How much rates vary
Facilitymedian $1,000 · 10th to 90th $288 to $4,266Professionalmedian $240 · 10th to 90th $162 to $407
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 $134.90 Median $239.88 Typical High $407.38 | Professional | None | $134.90 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $302.00 | Professional | 54 · Surgery only | $120.23 | $177.83 | $302.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,621.81 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $426.58 | Professional | None | $186.21 | $309.03 | $426.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $169.82 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | None | $169.82 | $223.87 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $338.84 Typical High $5,495.41 | Facility | None | $123.03 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $407.38 | Professional | None | $162.18 | $239.88 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $302.00 | Professional | 54 · Surgery only | $120.23 | $177.83 | $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 $204.17 Median $204.17 Typical High $398.11 | Facility | None | $204.17 | $204.17 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $426.58 | Professional | None | $204.17 | $371.54 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $331.13 | Professional | None | $186.21 | $245.47 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $2,951.21 | Facility | None | $190.55 | $190.55 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $257.04 | Professional | None | $128.82 | $190.55 | $257.04 |
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 $131.83 Median $218.78 Typical High $371.54 | Professional | None | $131.83 | $218.78 | $371.54 |
11 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 $81.28 Median $120.23 Typical High $199.53 | Professional | 52 · Reduced service | $81.28 | $120.23 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $81.28 | Professional | 53 · Discontinued | $32.36 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $40.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.44 Typical High $44.67 | Professional | 55 · Aftercare only | $19.05 | $23.44 | $44.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $275.42 Typical High $501.19 | Professional | 63 · Small infant | $229.09 | $275.42 | $501.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $162.18 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $128.82 | $162.18 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $120.23 Typical High $199.53 | Professional | 52 · Reduced service | $81.28 | $120.23 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $81.28 | Professional | 53 · Discontinued | $32.36 | $47.86 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $40.74 |
Where Idaho sits
The same service costs 4.0 times more in Alaska 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· 12th of 51
$288
AK $631KY $158
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.