How much rates vary
Facilitymedian $550 · 10th to 90th $123 to $3,981Professionalmedian $224 · 10th to 90th $148 to $316
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 $120.23 Median $316.23 Typical High $426.58 | Professional | None | $120.23 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $114.82 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $302.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $724.44 Typical High $3,981.07 | Facility | None | $128.82 | $724.44 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $316.23 | Professional | None | $190.55 | $223.87 | $316.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $181.97 | $251.19 | $281.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $19.05 | $21.38 | $29.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $165.96 | Facility | None | $109.65 | $123.03 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $234.42 | Professional | None | $147.91 | $177.83 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $5,495.41 | Facility | None | $125.89 | $426.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $426.58 | Professional | None | $151.36 | $263.03 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $114.82 | $239.88 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $302.00 |
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 $199.53 Median $199.53 Typical High $288.40 | Facility | None | $199.53 | $199.53 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $295.12 | Professional | None | $199.53 | $218.78 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $151.36 | $151.36 | $199.53 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $213.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $295.12 | Professional | None | $213.80 | $229.09 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $1,380.38 | Facility | None | $138.04 | $141.25 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $208.93 | Professional | None | $125.89 | $138.04 | $208.93 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $281.84 | Professional | None | $117.49 | $169.82 | $281.84 |
8 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 $75.86 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $75.86 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $30.20 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $15.14 | $31.62 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $331.13 Typical High $380.19 | Professional | 63 · Small infant | $223.87 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $75.86 | $158.49 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $30.20 | $63.10 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $15.14 | $31.62 | $42.66 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $28.84 |
Where Idaho sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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 $437NJ $110
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.