How much rates vary
Facilitymedian $234 · 10th to 90th $98 to $2,512Professionalmedian $102 · 10th to 90th $65 to $214
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 $75.86 Median $204.17 Typical High $5,495.41 | Facility | None | $75.86 | $204.17 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $194.98 | Professional | None | $57.54 | $95.50 | $194.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $1,096.48 | Facility | None | $128.82 | $229.09 | $1,096.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $223.87 | Professional | None | $75.86 | $158.49 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $162.18 | Professional | None | $72.44 | $95.50 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $660.69 Typical High $8,128.31 | Facility | None | $89.13 | $660.69 | $8,128.31 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $269.15 | Professional | None | $58.88 | $117.49 | $269.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $204.17 | Facility | None | $87.10 | $87.10 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $208.93 | Professional | None | $87.10 | $158.49 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $263.03 | Facility | None | $165.96 | $177.83 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $181.97 | Professional | None | $75.86 | $100.00 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $2,137.96 | Facility | None | $97.72 | $100.00 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $138.04 | Professional | None | $53.70 | $97.72 | $138.04 |
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 $56.23 Median $95.50 Typical High $141.25 | Professional | None | $56.23 | $95.50 | $141.25 |
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 $29.51 Median $44.67 Typical High $97.72 | Professional | 52 · Reduced service | $29.51 | $44.67 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.78 Typical High $38.90 | Professional | 53 · Discontinued | $11.75 | $17.78 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $67.61 Typical High $147.91 | Professional | 54 · Surgery only | $44.67 | $67.61 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.49 Typical High $29.51 | Professional | 55 · Aftercare only | $8.91 | $13.49 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.91 Typical High $19.50 | Professional | 56 · Pre-op care only | $5.89 | $8.91 | $19.50 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $208.93 | Professional | 54 · Surgery only | $72.44 | $85.11 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $7.94 | $19.05 | $22.39 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $95.50 Median $190.55 Typical High $275.42 | Professional | 63 · Small infant | $95.50 | $190.55 | $275.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $138.04 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $56.23 | $138.04 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $57.54 Typical High $97.72 | Professional | 52 · Reduced service | $29.51 | $57.54 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $25.12 Typical High $38.90 | Professional | 53 · Discontinued | $11.75 | $25.12 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $67.61 Typical High $147.91 | Professional | 54 · Surgery only | $44.67 | $67.61 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.49 Typical High $29.51 | Professional | 55 · Aftercare only | $8.91 | $13.49 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.91 Typical High $19.50 | Professional | 56 · Pre-op care only | $5.89 | $8.91 | $19.50 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in New York. 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· 7th of 51
$129
AK $251NY $77.62
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.