How much rates vary
Facilitymedian $407 · 10th to 90th $135 to $2,344Professionalmedian $138 · 10th to 90th $66 to $309
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 $208.93 Median $1,412.54 Typical High $7,079.46 | Facility | None | $208.93 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $138.04 Typical High $380.19 | Professional | None | $52.48 | $138.04 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $104.71 Typical High $281.84 | Professional | 54 · Surgery only | $48.98 | $104.71 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $20.89 Typical High $56.23 | Professional | 55 · Aftercare only | $9.77 | $20.89 | $56.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $512.86 Typical High $2,398.83 | Facility | None | $134.90 | $512.86 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $194.98 Typical High $309.03 | Professional | None | $83.18 | $194.98 | $309.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $269.15 | Professional | 54 · Surgery only | $72.44 | $85.11 | $269.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $30.90 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $199.53 | Facility | None | $128.82 | $147.91 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $204.17 | Professional | None | $66.07 | $102.33 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $331.13 Typical High $4,466.84 | Facility | None | $66.07 | $331.13 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $380.19 | Professional | None | $66.07 | $138.04 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $104.71 Typical High $281.84 | Professional | 54 · Surgery only | $48.98 | $104.71 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $20.89 Typical High $56.23 | Professional | 55 · Aftercare only | $9.77 | $20.89 | $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 $87.10 Median $87.10 Typical High $288.40 | Facility | None | $87.10 | $87.10 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $288.40 | Professional | None | $87.10 | $147.91 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $104.71 Typical High $173.78 | Professional | 54 · Surgery only | $66.07 | $104.71 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,318.26 | $2,041.74 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $257.04 | Professional | None | $91.20 | $120.23 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $1,148.15 | Facility | None | $138.04 | $138.04 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $162.18 | Professional | None | $54.95 | $138.04 | $162.18 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $52.48 Median $120.23 Typical High $223.87 | Professional | None | $52.48 | $120.23 | $223.87 |
10 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 $33.11 Median $69.18 Typical High $190.55 | Professional | 52 · Reduced service | $33.11 | $69.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $27.54 Typical High $75.86 | Professional | 53 · Discontinued | $13.18 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.80 Typical High $38.02 | Professional | 56 · Pre-op care only | $6.61 | $13.80 | $38.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $107.15 Median $114.82 Typical High $363.08 | Professional | 63 · Small infant | $107.15 | $114.82 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $173.78 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $56.23 | $173.78 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $69.18 Typical High $190.55 | Professional | 52 · Reduced service | $33.11 | $69.18 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $27.54 Typical High $75.86 | Professional | 53 · Discontinued | $13.18 | $27.54 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.80 Typical High $38.02 | Professional | 56 · Pre-op care only | $6.61 | $13.80 | $38.02 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.79 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.33 | $14.79 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $112.20 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $70.79 | $112.20 | $186.21 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 13th of 51
$138
AK $224DC $63.10
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.