How much rates vary
Facilitymedian $209 · 10th to 90th $112 to $676Professionalmedian $178 · 10th to 90th $117 to $275
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $245.47 | Professional | None | $109.65 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.30 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $26.30 | $37.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $295.12 Typical High $691.83 | Facility | None | $112.20 | $295.12 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $28.18 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $154.88 | Facility | None | $102.33 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | None | $117.49 | $138.04 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $346.74 | Facility | None | $95.50 | $173.78 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $245.47 | Professional | None | $134.90 | $208.93 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.30 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $26.30 | $37.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $269.15 | Facility | None | $158.49 | $158.49 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $338.84 | Professional | None | $158.49 | $199.53 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $870.96 | Facility | None | $467.74 | $676.08 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $295.12 | Professional | None | $177.83 | $208.93 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $549.54 | Facility | None | $128.82 | $128.82 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $162.18 | Professional | None | $87.10 | $128.82 | $162.18 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | None | $95.50 | $144.54 | $234.42 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $87.10 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $24.55 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $165.96 Median $446.68 Typical High $1,047.13 | Facility | 50 · Both sides | $165.96 | $446.68 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $338.84 Typical High $436.52 | Professional | 50 · Both sides | $223.87 | $338.84 | $436.52 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $158.49 Typical High $263.03 | Professional | 54 · Surgery only | $131.83 | $158.49 | $263.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $213.80 Typical High $338.84 | Professional | 63 · Small infant | $173.78 | $213.80 | $338.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $102.33 | $158.49 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $87.10 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $87.10 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $34.67 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $288.40 Typical High $416.87 | Professional | 50 · Both sides | $288.40 | $288.40 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $134.90 | $134.90 | $194.98 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $27.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $208.93 |
Where Idaho sits
The same service costs 3.6 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 11th of 51
$178
AK $355KY $97.72
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.