How much rates vary
Facilitymedian $380 · 10th to 90th $170 to $1,698Professionalmedian $182 · 10th to 90th $123 to $331
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $331.13 | Professional | None | $123.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $93.33 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $18.62 | $48.98 | $48.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $1,698.24 | Facility | None | $331.13 | $870.96 | $1,698.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $218.78 | Professional | None | $162.18 | $190.55 | $218.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $147.91 | $169.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $21.88 |
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 $131.83 Median $158.49 Typical High $181.97 | Professional | None | $131.83 | $158.49 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $331.13 Typical High $5,495.41 | Facility | None | $112.20 | $331.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $331.13 | Professional | None | $138.04 | $204.17 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $104.71 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $20.89 | $48.98 | $48.98 |
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 $144.54 Median $177.83 Typical High $177.83 | Facility | None | $144.54 | $177.83 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | None | $177.83 | $177.83 | $218.78 |
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 $1,122.02 Typical High $1,412.54 | Facility | None | $776.25 | $1,122.02 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | None | $177.83 | $208.93 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $2,344.23 | Facility | None | $83.18 | $85.11 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $199.53 | Professional | None | $83.18 | $83.18 | $199.53 |
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 $107.15 Median $144.54 Typical High $199.53 | Professional | None | $107.15 | $144.54 | $199.53 |
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 $61.66 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $61.66 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $24.55 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.30 | $33.11 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $194.98 Median $223.87 Typical High $263.03 | Professional | 63 · Small infant | $194.98 | $223.87 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $114.82 | $131.83 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $69.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $27.54 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.80 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 22 · Increased work | $239.88 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 63 · Small infant | $239.88 | $239.88 | $239.88 |
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 4.8 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
$186
AK $427FL $89.13
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.