How much rates vary
Facilitymedian $550 · 10th to 90th $151 to $871Professionalmedian $209 · 10th to 90th $138 to $288
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 $128.82 Median $288.40 Typical High $288.40 | Professional | None | $128.82 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $22.39 | $43.65 | $43.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $436.52 Median $467.74 Typical High $562.34 | Facility | None | $436.52 | $467.74 | $562.34 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $251.19 | Professional | None | $190.55 | $223.87 | $251.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $208.93 | Professional | 54 · Surgery only | $169.82 | $199.53 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $199.53 | Professional | None | $147.91 | $177.83 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $288.40 Typical High $5,495.41 | Facility | None | $100.00 | $288.40 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $288.40 | Professional | None | $151.36 | $229.09 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $22.39 | $43.65 | $43.65 |
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 $169.82 Median $208.93 Typical High $208.93 | Facility | None | $169.82 | $208.93 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $263.03 | Professional | None | $208.93 | $208.93 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $281.84 | Professional | None | $213.80 | $251.19 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $112.20 | Facility | None | $100.00 | $100.00 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | None | $100.00 | $100.00 | $151.36 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $269.15 | Professional | None | $125.89 | $181.97 | $269.15 |
8 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 $75.86 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $75.86 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $30.20 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.14 | $28.84 | $28.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $263.03 Typical High $281.84 | Professional | 63 · Small infant | $223.87 | $263.03 | $281.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $75.86 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $30.20 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.14 | $28.84 | $28.84 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$219
AK $513UT $132
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.