How much rates vary
Facilitymedian $178 · 10th to 90th $85 to $603Professionalmedian $166 · 10th to 90th $107 to $251
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $218.78 | Professional | None | $93.33 | $151.36 | $218.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $93.33 Median $194.98 Typical High $602.56 | Facility | None | $93.33 | $194.98 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $263.03 | Professional | None | $138.04 | $194.98 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $114.82 | Facility | None | $75.86 | $85.11 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $194.98 | Professional | None | $125.89 | $154.88 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $218.78 Typical High $5,495.41 | Facility | None | $107.15 | $218.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $251.19 | Professional | None | $107.15 | $173.78 | $251.19 |
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 $158.49 Median $158.49 Typical High $239.88 | Facility | None | $158.49 | $158.49 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $275.42 | Professional | None | $158.49 | $239.88 | $275.42 |
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 $138.04 Median $173.78 Typical High $208.93 | Professional | None | $138.04 | $173.78 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $309.03 | Facility | None | $114.82 | $117.49 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $158.49 | Professional | None | $102.33 | $114.82 | $158.49 |
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 $100.00 Median $144.54 Typical High $213.80 | Professional | None | $100.00 | $144.54 | $213.80 |
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 $52.48 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $52.48 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $21.38 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $79.43 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $21.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $223.87 | Professional | 54 · Surgery only | $131.83 | $154.88 | $223.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $26.92 | Professional | 55 · Aftercare only | $14.45 | $17.38 | $26.92 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $177.83 Median $269.15 Typical High $323.59 | Professional | 63 · Small infant | $177.83 | $269.15 | $323.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $52.48 | $77.62 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $21.38 | $30.90 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $79.43 | $117.49 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $21.88 |
Where Idaho sits
The same service costs 3.7 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· 15th of 51
$166
AK $372KY $100
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.