How much rates vary
Facilitymedian $182 · 10th to 90th $100 to $661Professionalmedian $166 · 10th to 90th $112 to $234
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $229.09 | Professional | None | $97.72 | $158.49 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $104.71 Median $234.42 Typical High $645.65 | Facility | None | $104.71 | $234.42 | $645.65 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $257.04 | Professional | None | $134.90 | $181.97 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $134.90 | Facility | None | $89.13 | $100.00 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | None | $117.49 | $141.25 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $199.53 Typical High $758.58 | Facility | None | $91.20 | $199.53 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $229.09 | Professional | None | $114.82 | $169.82 | $229.09 |
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 $162.18 Median $162.18 Typical High $234.42 | Facility | None | $162.18 | $162.18 | $234.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $263.03 | Professional | None | $162.18 | $234.42 | $263.03 |
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 $134.90 Median $169.82 Typical High $190.55 | Professional | None | $134.90 | $169.82 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $562.34 | Facility | None | $112.20 | $114.82 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $151.36 | Professional | None | $102.33 | $112.20 | $151.36 |
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 $91.20 Median $141.25 Typical High $204.17 | Professional | None | $91.20 | $141.25 | $204.17 |
16 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 $57.54 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $87.10 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $33.88 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $158.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $158.49 | $239.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $26.30 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $269.15 Typical High $316.23 | Professional | 63 · Small infant | $181.97 | $269.15 | $316.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $104.71 | $138.04 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $85.11 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $33.88 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $87.10 | $128.82 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $33.88 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $22.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $158.49 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 10th of 51
$166
AK $355PA $107
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.