How much rates vary
Facilitymedian $178 · 10th to 90th $65 to $603Professionalmedian $123 · 10th to 90th $87 to $204
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 $138.04 Median $1,412.54 Typical High $7,079.46 | Facility | None | $138.04 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $177.83 | Professional | None | $74.13 | $114.82 | $177.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $223.87 Typical High $602.56 | Facility | None | $72.44 | $223.87 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $204.17 | Professional | None | $97.72 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $87.10 | Facility | None | $57.54 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $158.49 | Professional | None | $89.13 | $123.03 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $1,412.54 | Facility | None | $102.33 | $177.83 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $398.11 | Professional | None | $83.18 | $128.82 | $398.11 |
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 $107.15 Median $107.15 Typical High $190.55 | Facility | None | $107.15 | $107.15 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $204.17 | Professional | None | $107.15 | $190.55 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $645.65 | Facility | None | $331.13 | $501.19 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $177.83 | Professional | None | $97.72 | $141.25 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $309.03 | Facility | None | $91.20 | $91.20 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $125.89 | Professional | None | $67.61 | $91.20 | $125.89 |
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 $77.62 Median $131.83 Typical High $199.53 | Professional | None | $77.62 | $131.83 | $199.53 |
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 $37.15 Median $54.95 Typical High $89.13 | Professional | 52 · Reduced service | $37.15 | $54.95 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.88 Typical High $35.48 | Professional | 53 · Discontinued | $14.79 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $83.18 Typical High $134.90 | Professional | 54 · Surgery only | $54.95 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 55 · Aftercare only | $10.96 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.96 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.41 | $10.96 | $17.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $190.55 | Professional | 54 · Surgery only | $89.13 | $107.15 | $190.55 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $10.23 | $16.98 | $21.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $117.49 Median $204.17 Typical High $257.04 | Professional | 63 · Small infant | $117.49 | $204.17 | $257.04 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $83.18 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $69.18 | $83.18 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $54.95 Typical High $89.13 | Professional | 52 · Reduced service | $37.15 | $54.95 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.99 Typical High $35.48 | Professional | 53 · Discontinued | $14.79 | $23.99 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $83.18 Typical High $134.90 | Professional | 54 · Surgery only | $54.95 | $83.18 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 55 · Aftercare only | $10.96 | $16.60 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.96 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.41 | $10.96 | $17.78 |
Where Idaho sits
The same service costs 3.0 times more in Wisconsin 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· 18th of 51
$132
WI $282KY $93.33
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.