How much rates vary
Facilitymedian $148 · 10th to 90th $26 to $389Professionalmedian $34 · 10th to 90th $20 to $59
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 $51.29 Median $57.54 Typical High $104.71 | Facility | None | $51.29 | $57.54 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $40.74 Typical High $87.10 | Professional | None | $15.85 | $40.74 | $87.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $58.88 Median $169.82 Typical High $389.05 | Facility | None | $58.88 | $169.82 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $23.99 Median $46.77 Typical High $60.26 | Professional | None | $23.99 | $46.77 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $46.77 | Professional | None | $20.42 | $30.20 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $69.18 Typical High $223.87 | Facility | None | $21.38 | $69.18 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $47.86 Typical High $87.10 | Professional | None | $21.38 | $47.86 | $87.10 |
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 $26.30 Median $26.30 Typical High $53.70 | Facility | None | $26.30 | $26.30 | $53.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $53.70 | Professional | None | $26.30 | $31.62 | $53.70 |
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 $26.30 Median $30.90 Typical High $54.95 | Professional | None | $26.30 | $30.90 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $25.70 Median $26.30 Typical High $125.89 | Facility | None | $25.70 | $26.30 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $16.22 Median $25.70 Typical High $35.48 | Professional | None | $16.22 | $25.70 | $35.48 |
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 $16.98 Median $30.90 Typical High $57.54 | Professional | None | $16.98 | $30.90 | $57.54 |
14 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 $10.00 Median $23.99 Typical High $43.65 | Professional | 52 · Reduced service | $10.00 | $23.99 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $9.55 Typical High $17.38 | Professional | 53 · Discontinued | $3.98 | $9.55 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $36.31 Typical High $66.07 | Professional | 54 · Surgery only | $14.79 | $36.31 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $7.24 Typical High $13.18 | Professional | 55 · Aftercare only | $2.95 | $7.24 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $4.79 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.00 | $4.79 | $8.71 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $26.30 Typical High $54.95 | Professional | 54 · Surgery only | $21.38 | $26.30 | $54.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.16 Typical High $5.89 | Professional | 55 · Aftercare only | $2.40 | $3.16 | $5.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $28.84 Median $38.02 Typical High $72.44 | Professional | 63 · Small infant | $28.84 | $38.02 | $72.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.98 Median $20.42 Typical High $40.74 | Professional | 78 · Unplanned return to OR | $16.98 | $20.42 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $23.99 Typical High $43.65 | Professional | 52 · Reduced service | $10.47 | $23.99 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $9.55 Typical High $17.38 | Professional | 53 · Discontinued | $4.17 | $9.55 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $36.31 Typical High $66.07 | Professional | 54 · Surgery only | $15.85 | $36.31 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $7.24 Typical High $13.18 | Professional | 55 · Aftercare only | $3.16 | $7.24 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $4.79 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.09 | $4.79 | $8.71 |
Where Idaho sits
The same service costs 3.5 times more in Wisconsin 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· 8th of 51
$46.77
WI $87.10KY $25.12
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.