How much rates vary
Facilitymedian $129 · 10th to 90th $48 to $417Professionalmedian $91 · 10th to 90th $60 to $135
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 $91.20 Typical High $128.82 | Professional | None | $54.95 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.49 Typical High $19.50 | Professional | 55 · Aftercare only | $8.32 | $13.49 | $19.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $50.12 Median $123.03 Typical High $407.38 | Facility | None | $50.12 | $123.03 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $141.25 | Professional | None | $69.18 | $97.72 | $141.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $14.13 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $64.57 | Facility | None | $42.66 | $47.86 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $97.72 | Professional | None | $60.26 | $72.44 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $128.82 | Facility | None | $50.12 | $91.20 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $128.82 | Professional | None | $64.57 | $107.15 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.49 Typical High $19.50 | Professional | 55 · Aftercare only | $8.32 | $13.49 | $19.50 |
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 $75.86 Median $75.86 Typical High $128.82 | Facility | None | $75.86 | $75.86 | $128.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $162.18 | Professional | None | $75.86 | $97.72 | $162.18 |
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 $89.13 Median $107.15 Typical High $151.36 | Professional | None | $89.13 | $107.15 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $316.23 | Facility | None | $61.66 | $63.10 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $83.18 | Professional | None | $43.65 | $61.66 | $83.18 |
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 $47.86 Median $74.13 Typical High $117.49 | Professional | None | $47.86 | $74.13 | $117.49 |
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 $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $27.54 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.20 Typical High $25.70 | Professional | 53 · Discontinued | $10.96 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.50 | $9.12 | $12.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $104.71 Typical High $131.83 | Professional | 54 · Surgery only | $64.57 | $104.71 | $131.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $83.18 Median $141.25 Typical High $173.78 | Professional | 63 · Small infant | $83.18 | $141.25 | $173.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $58.88 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $48.98 | $58.88 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $27.54 | $45.71 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.20 Typical High $25.70 | Professional | 53 · Discontinued | $10.96 | $18.20 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.50 | $9.12 | $12.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $69.18 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $14.45 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $74.13 | $74.13 | $109.65 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 9th of 51
$91.20
AK $182FL $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.