How much rates vary
Facilitymedian $251 · 10th to 90th $107 to $776Professionalmedian $123 · 10th to 90th $72 to $263
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 $141.25 Median $323.59 Typical High $5,495.41 | Facility | None | $141.25 | $323.59 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $269.15 | Professional | None | $61.66 | $120.23 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $89.13 Typical High $204.17 | Professional | 54 · Surgery only | $46.77 | $89.13 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $17.78 Typical High $40.74 | Professional | 55 · Aftercare only | $9.33 | $17.78 | $40.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $302.00 Typical High $776.25 | Facility | None | $109.65 | $302.00 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $251.19 | Professional | None | $85.11 | $177.83 | $251.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $87.10 Typical High $229.09 | Professional | 54 · Surgery only | $74.13 | $87.10 | $229.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.00 Typical High $24.55 | Professional | 55 · Aftercare only | $8.13 | $10.00 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $151.36 | Facility | None | $100.00 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $123.03 Typical High $173.78 | Professional | None | $67.61 | $123.03 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $380.19 Typical High $1,412.54 | Facility | None | $112.20 | $380.19 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $269.15 | Professional | None | $77.62 | $131.83 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $89.13 Typical High $204.17 | Professional | 54 · Surgery only | $46.77 | $89.13 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $17.78 Typical High $40.74 | Professional | 55 · Aftercare only | $9.33 | $17.78 | $40.74 |
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 $89.13 Median $89.13 Typical High $234.42 | Facility | None | $89.13 | $89.13 | $234.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $295.12 | Professional | None | $89.13 | $123.03 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $194.98 | Professional | 54 · Surgery only | $87.10 | $87.10 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $977.24 | Facility | None | $501.19 | $724.44 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $263.03 | Professional | None | $102.33 | $138.04 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $537.03 | Facility | None | $112.20 | $112.20 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $138.04 | Professional | None | $50.12 | $102.33 | $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 $58.88 Median $114.82 Typical High $213.80 | Professional | None | $58.88 | $114.82 | $213.80 |
13 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 $30.90 Median $58.88 Typical High $134.90 | Professional | 52 · Reduced service | $30.90 | $58.88 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $23.99 Typical High $53.70 | Professional | 53 · Discontinued | $12.30 | $23.99 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.02 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.17 | $12.02 | $26.92 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $162.18 Median $446.68 Typical High $1,148.15 | Facility | 50 · Both sides | $162.18 | $446.68 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $269.15 Typical High $389.05 | Professional | 50 · Both sides | $123.03 | $269.15 | $389.05 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $97.72 Median $147.91 Typical High $295.12 | Professional | 63 · Small infant | $97.72 | $147.91 | $295.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $67.61 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $57.54 | $67.61 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $58.88 Typical High $134.90 | Professional | 52 · Reduced service | $30.90 | $58.88 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $23.99 Typical High $53.70 | Professional | 53 · Discontinued | $12.30 | $23.99 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.02 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.17 | $12.02 | $26.92 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $186.21 Typical High $416.87 | Professional | 50 · Both sides | $186.21 | $186.21 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $27.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $208.93 |
Where Idaho sits
The same service costs 3.4 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· 16th of 51
$126
AK $234KY $69.18
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.