How much rates vary
Facilitymedian $141 · 10th to 90th $45 to $525Professionalmedian $87 · 10th to 90th $56 to $145
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 $48.98 Median $81.28 Typical High $128.82 | Professional | None | $48.98 | $81.28 | $128.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $53.70 Median $194.98 Typical High $602.56 | Facility | None | $53.70 | $194.98 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $147.91 | Professional | None | $70.79 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $61.66 | Facility | None | $39.81 | $44.67 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $114.82 | Professional | None | $64.57 | $83.18 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $4,466.84 | Facility | None | $53.70 | $89.13 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $144.54 | Professional | None | $53.70 | $89.13 | $144.54 |
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 $77.62 Median $77.62 Typical High $134.90 | Facility | None | $77.62 | $77.62 | $134.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $144.54 | Professional | None | $77.62 | $134.90 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $645.65 | Facility | None | $331.13 | $467.74 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $123.03 | Professional | None | $70.79 | $91.20 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $309.03 | Facility | None | $64.57 | $66.07 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $93.33 | Professional | None | $48.98 | $64.57 | $93.33 |
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 $51.29 Median $81.28 Typical High $138.04 | Professional | None | $51.29 | $81.28 | $138.04 |
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 $26.92 Median $39.81 Typical High $64.57 | Professional | 52 · Reduced service | $26.92 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $25.70 | Professional | 53 · Discontinued | $10.72 | $15.85 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $97.72 | Professional | 54 · Surgery only | $39.81 | $60.26 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.02 Typical High $19.50 | Professional | 55 · Aftercare only | $8.13 | $12.02 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $12.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $79.43 Typical High $131.83 | Professional | 54 · Surgery only | $63.10 | $79.43 | $131.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $14.79 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $14.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $87.10 Median $123.03 Typical High $181.97 | Professional | 63 · Small infant | $87.10 | $123.03 | $181.97 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $85.11 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $52.48 | $85.11 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $39.81 Typical High $64.57 | Professional | 52 · Reduced service | $26.92 | $39.81 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $25.70 | Professional | 53 · Discontinued | $10.72 | $15.85 | $25.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $97.72 | Professional | 54 · Surgery only | $39.81 | $60.26 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.02 Typical High $19.50 | Professional | 55 · Aftercare only | $8.13 | $12.02 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $12.88 |
Where Idaho sits
The same service costs 3.1 times more in Wisconsin 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· 18th of 51
$89.13
WI $200DC $64.57
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.