How much rates vary
Facilitymedian $380 · 10th to 90th $62 to $1,820Professionalmedian $135 · 10th to 90th $81 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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $218.78 | Professional | None | $70.79 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $104.71 Typical High $162.18 | Professional | 54 · Surgery only | $52.48 | $104.71 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $20.89 Typical High $32.36 | Professional | 55 · Aftercare only | $10.47 | $20.89 | $32.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $524.81 Typical High $2,089.30 | Facility | None | $61.66 | $524.81 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $190.55 | Professional | None | $87.10 | $138.04 | $190.55 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $173.78 | Professional | 54 · Surgery only | $79.43 | $95.50 | $173.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $19.95 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $85.11 | Facility | None | $54.95 | $63.10 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $141.25 | Professional | None | $81.28 | $100.00 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $199.53 Typical High $5,495.41 | Facility | None | $70.79 | $199.53 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $218.78 | Professional | None | $79.43 | $138.04 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $104.71 Typical High $162.18 | Professional | 54 · Surgery only | $52.48 | $104.71 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $20.89 Typical High $32.36 | Professional | 55 · Aftercare only | $10.47 | $20.89 | $32.36 |
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 $95.50 Median $95.50 Typical High $173.78 | Facility | None | $95.50 | $95.50 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $223.87 | Professional | None | $95.50 | $138.04 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $97.72 | $151.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,230.27 | $1,778.28 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $208.93 | Professional | None | $109.65 | $134.90 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $812.83 | Facility | None | $83.18 | $85.11 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $83.18 Typical High $109.65 | Professional | None | $56.23 | $83.18 | $109.65 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $218.78 | Professional | None | $67.61 | $117.49 | $218.78 |
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 $35.48 Median $69.18 Typical High $107.15 | Professional | 52 · Reduced service | $35.48 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $27.54 Typical High $43.65 | Professional | 53 · Discontinued | $14.13 | $27.54 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.80 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.08 | $13.80 | $21.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $91.20 Median $707.95 Typical High $3,162.28 | Facility | 50 · Both sides | $91.20 | $707.95 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $154.88 Typical High $281.84 | Professional | 50 · Both sides | $131.83 | $154.88 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $104.71 Median $165.96 Typical High $229.09 | Professional | 63 · Small infant | $104.71 | $165.96 | $229.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $97.72 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $63.10 | $97.72 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $69.18 Typical High $107.15 | Professional | 52 · Reduced service | $35.48 | $69.18 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $27.54 Typical High $43.65 | Professional | 53 · Discontinued | $14.13 | $27.54 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.80 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.08 | $13.80 | $21.88 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | 50 · Both sides | $208.93 | $208.93 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $21.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $162.18 |
Where Idaho sits
The same service costs 3.2 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· 10th of 51
$138
AK $224KY $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.