How much rates vary
Facilitymedian $363 · 10th to 90th $170 to $1,318Professionalmedian $224 · 10th to 90th $141 to $372
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $371.54 Typical High $371.54 | Professional | None | $141.25 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $107.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $21.38 | $56.23 | $56.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $1,318.26 | Facility | None | $288.40 | $467.74 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | None | $199.53 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $177.83 | $199.53 | $218.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.39 Typical High $23.99 | Professional | 55 · Aftercare only | $19.95 | $22.39 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $407.38 | Facility | None | $269.15 | $302.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $204.17 | Professional | None | $154.88 | $177.83 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $371.54 Typical High $5,495.41 | Facility | None | $154.88 | $371.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $371.54 | Professional | None | $154.88 | $234.42 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $117.49 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $23.44 | $56.23 | $56.23 |
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 $173.78 Median $213.80 Typical High $213.80 | Facility | None | $173.78 | $213.80 | $213.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,412.54 | Facility | None | $776.25 | $1,096.48 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | None | $208.93 | $245.47 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $977.24 | Facility | None | $102.33 | $104.71 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $223.87 | Professional | None | $102.33 | $102.33 | $223.87 |
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 $128.82 Median $173.78 Typical High $239.88 | Professional | None | $128.82 | $173.78 | $239.88 |
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 $72.44 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $72.44 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $28.84 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $14.45 | $37.15 | $37.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | 63 · Small infant | $239.88 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $77.62 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $30.90 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.49 | $37.15 | $37.15 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 22 · Increased work | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 63 · Small infant | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$224
AK $501UT $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.