How much rates vary
Facilitymedian $151 · 10th to 90th $48 to $661Professionalmedian $51 · 10th to 90th $35 to $76
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 $30.20 Median $46.77 Typical High $66.07 | Professional | None | $30.20 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $38.02 Typical High $50.12 | Professional | 54 · Surgery only | $25.12 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $7.59 | $10.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $660.69 | Facility | None | $81.28 | $134.90 | $660.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $81.28 | Professional | None | $44.67 | $58.88 | $81.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $50.12 Typical High $74.13 | Professional | 54 · Surgery only | $40.74 | $50.12 | $74.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.50 Typical High $8.51 | Professional | 55 · Aftercare only | $4.47 | $5.50 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $60.26 | Professional | None | $40.74 | $48.98 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $50.12 Typical High $5,495.41 | Facility | None | $33.88 | $50.12 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $74.13 | Professional | None | $33.88 | $51.29 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $38.02 Typical High $50.12 | Professional | 54 · Surgery only | $25.12 | $38.02 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $7.59 | $10.00 |
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 $48.98 Median $48.98 Typical High $75.86 | Facility | None | $48.98 | $48.98 | $75.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | None | $48.98 | $64.57 | $75.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $64.57 | Professional | None | $44.67 | $56.23 | $64.57 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $281.84 | Facility | None | $36.31 | $37.15 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $47.86 | Professional | None | $30.90 | $36.31 | $47.86 |
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 $32.36 Median $47.86 Typical High $69.18 | Professional | None | $32.36 | $47.86 | $69.18 |
9 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 $16.98 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $16.98 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $10.00 Typical High $13.18 | Professional | 53 · Discontinued | $6.76 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.01 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.39 | $5.01 | $6.61 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $29.51 Median $40.74 Typical High $51.29 | Professional | 62 · Two surgeons | $29.51 | $40.74 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $54.95 Median $66.07 Typical High $97.72 | Professional | 63 · Small infant | $54.95 | $66.07 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $38.90 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $31.62 | $38.90 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $16.98 | $25.12 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $10.00 Typical High $13.18 | Professional | 53 · Discontinued | $6.76 | $10.00 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.01 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.39 | $5.01 | $6.61 |
Where Idaho sits
The same service costs 3.3 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· 16th of 51
$53.70
AK $117KY $35.48
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.