How much rates vary
Facilitymedian $145 · 10th to 90th $81 to $417Professionalmedian $95 · 10th to 90th $60 to $191
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 $54.95 Median $87.10 Typical High $169.82 | Professional | None | $54.95 | $87.10 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.18 Typical High $25.12 | Professional | 55 · Aftercare only | $8.13 | $13.18 | $25.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $85.11 Median $134.90 Typical High $407.38 | Facility | None | $85.11 | $134.90 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $204.17 | Professional | None | $69.18 | $144.54 | $204.17 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $9.55 Typical High $20.42 | Professional | 55 · Aftercare only | $6.92 | $9.55 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $120.23 | Facility | None | $79.43 | $89.13 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $128.82 | Professional | None | $60.26 | $83.18 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $87.10 Typical High $169.82 | Facility | None | $47.86 | $87.10 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $173.78 | Professional | None | $64.57 | $102.33 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.18 Typical High $25.12 | Professional | 55 · Aftercare only | $8.13 | $13.18 | $25.12 |
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 $74.13 Median $74.13 Typical High $190.55 | Facility | None | $74.13 | $74.13 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $239.88 | Professional | None | $74.13 | $95.50 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Facility | None | $275.42 | $389.05 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $204.17 | Professional | None | $87.10 | $102.33 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $316.23 | Facility | None | $89.13 | $91.20 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $112.20 | Professional | None | $43.65 | $81.28 | $112.20 |
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 $47.86 Median $89.13 Typical High $151.36 | Professional | None | $47.86 | $89.13 | $151.36 |
12 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 $27.54 Median $43.65 Typical High $85.11 | Professional | 52 · Reduced service | $27.54 | $43.65 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $33.88 | Professional | 53 · Discontinued | $10.96 | $17.38 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $16.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $74.13 Typical High $181.97 | Professional | 54 · Surgery only | $61.66 | $74.13 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $81.28 Median $190.55 Typical High $239.88 | Professional | 63 · Small infant | $81.28 | $190.55 | $239.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $56.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $47.86 | $56.23 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $43.65 Typical High $85.11 | Professional | 52 · Reduced service | $27.54 | $43.65 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $33.88 | Professional | 53 · Discontinued | $10.96 | $17.38 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $134.90 | Professional | 54 · Surgery only | $66.07 | $66.07 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $19.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $144.54 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 12th of 51
$95.50
AK $204VA $52.48
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.