How much rates vary
Facilitymedian $151 · 10th to 90th $66 to $741Professionalmedian $87 · 10th to 90th $43 to $170
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 $44.67 Median $1,412.54 Typical High $7,079.46 | Facility | None | $44.67 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $83.18 Typical High $173.78 | Professional | None | $38.90 | $83.18 | $173.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $234.42 Typical High $645.65 | Facility | None | $72.44 | $234.42 | $645.65 |
BCBS Idaho Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $169.82 | Professional | None | $45.71 | $117.49 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $93.33 | Facility | None | $61.66 | $69.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $123.03 | Professional | None | $42.66 | $87.10 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $144.54 Typical High $4,466.84 | Facility | None | $44.67 | $144.54 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $173.78 | Professional | None | $39.81 | $95.50 | $173.78 |
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 $51.29 Median $51.29 Typical High $151.36 | Facility | None | $51.29 | $51.29 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $162.18 | Professional | None | $51.29 | $91.20 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $812.83 | Facility | None | $467.74 | $602.56 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $134.90 | Professional | None | $45.71 | $74.13 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $512.86 | Facility | None | $72.44 | $74.13 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $95.50 | Professional | None | $32.36 | $72.44 | $95.50 |
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 $38.02 Median $81.28 Typical High $151.36 | Professional | None | $38.02 | $81.28 | $151.36 |
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 $19.50 Median $34.67 Typical High $87.10 | Professional | 52 · Reduced service | $19.50 | $34.67 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $34.67 | Professional | 53 · Discontinued | $7.76 | $13.80 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $52.48 Typical High $128.82 | Professional | 54 · Surgery only | $28.84 | $52.48 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $25.70 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $17.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $41.69 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $13.80 Typical High $16.98 | Professional | 55 · Aftercare only | $4.79 | $13.80 | $16.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $63.10 Median $169.82 Typical High $199.53 | Professional | 63 · Small infant | $63.10 | $169.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $63.10 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $33.11 | $63.10 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $34.67 Typical High $87.10 | Professional | 52 · Reduced service | $19.50 | $34.67 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $34.67 | Professional | 53 · Discontinued | $7.76 | $13.80 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $52.48 Typical High $128.82 | Professional | 54 · Surgery only | $28.84 | $52.48 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $25.70 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $17.38 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$97.72
WI $186NE $60.26
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.