How much rates vary
Facilitymedian $288 · 10th to 90th $95 to $631Professionalmedian $138 · 10th to 90th $74 to $347
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 Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $5,495.41 | Facility | None | $144.54 | $407.38 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $380.19 | Professional | None | $60.26 | $138.04 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $87.10 Median $204.17 Typical High $407.38 | Facility | None | $87.10 | $204.17 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $346.74 | Professional | None | $89.13 | $204.17 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $245.47 | Professional | None | $77.62 | $123.03 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $380.19 Typical High $812.83 | Facility | None | $95.50 | $380.19 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $147.91 Typical High $380.19 | Professional | None | $58.88 | $147.91 | $380.19 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $316.23 | Facility | None | $95.50 | $95.50 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $323.59 | Professional | None | $95.50 | $109.65 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $416.87 | Facility | None | $218.78 | $331.13 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $316.23 | Professional | None | $109.65 | $120.23 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $338.84 | Facility | None | $151.36 | $154.88 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $194.98 | Professional | None | $60.26 | $151.36 | $194.98 |
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 $61.66 Median $120.23 Typical High $218.78 | Professional | None | $61.66 | $120.23 | $218.78 |
16 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 $37.15 Median $69.18 Typical High $190.55 | Professional | 52 · Reduced service | $37.15 | $69.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $27.54 Typical High $77.62 | Professional | 53 · Discontinued | $14.79 | $27.54 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $102.33 Typical High $288.40 | Professional | 54 · Surgery only | $56.23 | $102.33 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $20.42 Typical High $57.54 | Professional | 55 · Aftercare only | $11.22 | $20.42 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.80 Typical High $38.02 | Professional | 56 · Pre-op care only | $7.41 | $13.80 | $38.02 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $128.82 Median $239.88 Typical High $512.86 | Facility | 50 · Both sides | $128.82 | $239.88 | $512.86 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $426.58 Typical High $537.03 | Professional | 50 · Both sides | $131.83 | $426.58 | $537.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $93.33 Typical High $295.12 | Professional | 54 · Surgery only | $79.43 | $93.33 | $295.12 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.47 Typical High $33.88 | Professional | 55 · Aftercare only | $8.91 | $10.47 | $33.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $107.15 Median $128.82 Typical High $416.87 | Professional | 63 · Small infant | $107.15 | $128.82 | $416.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $74.13 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $61.66 | $74.13 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $69.18 Typical High $190.55 | Professional | 52 · Reduced service | $37.15 | $69.18 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $27.54 Typical High $77.62 | Professional | 53 · Discontinued | $14.79 | $27.54 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $102.33 Typical High $288.40 | Professional | 54 · Surgery only | $56.23 | $102.33 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $20.42 Typical High $57.54 | Professional | 55 · Aftercare only | $11.22 | $20.42 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.80 Typical High $38.02 | Professional | 56 · Pre-op care only | $7.41 | $13.80 | $38.02 |
Where Idaho sits
The same service costs 4.0 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· 9th of 51
$162
AK $316KY $79.43
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.