How much rates vary
Facilitymedian $331 · 10th to 90th $98 to $1,820Professionalmedian $135 · 10th to 90th $81 to $269
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 $134.90 Median $1,412.54 Typical High $7,079.46 | Facility | None | $134.90 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $275.42 | Professional | None | $74.13 | $134.90 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $102.33 Typical High $204.17 | Professional | 54 · Surgery only | $51.29 | $102.33 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $40.74 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $40.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $575.44 Typical High $1,819.70 | Facility | None | $97.72 | $575.44 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $257.04 | Professional | None | $91.20 | $181.97 | $257.04 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $100.00 Typical High $208.93 | Professional | 54 · Surgery only | $81.28 | $100.00 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $9.12 | $21.38 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $144.54 | Facility | None | $93.33 | $104.71 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $181.97 | Professional | None | $77.62 | $125.89 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $275.42 Typical High $4,466.84 | Facility | None | $104.71 | $275.42 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $275.42 | Professional | None | $81.28 | $134.90 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $102.33 Typical High $204.17 | Professional | 54 · Surgery only | $56.23 | $102.33 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $20.42 Typical High $40.74 | Professional | 55 · Aftercare only | $11.22 | $20.42 | $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 $97.72 Median $97.72 Typical High $234.42 | Facility | None | $97.72 | $97.72 | $234.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $295.12 | Professional | None | $97.72 | $134.90 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $190.55 | Professional | 54 · Surgery only | $95.50 | $95.50 | $190.55 |
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 $107.15 Median $151.36 Typical High $269.15 | Professional | None | $107.15 | $151.36 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $794.33 | Facility | None | $112.20 | $114.82 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $138.04 | Professional | None | $54.95 | $95.50 | $138.04 |
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 $69.18 Median $141.25 Typical High $229.09 | Professional | None | $69.18 | $141.25 | $229.09 |
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 $34.67 Median $67.61 Typical High $134.90 | Professional | 52 · Reduced service | $34.67 | $67.61 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $26.92 Typical High $54.95 | Professional | 53 · Discontinued | $13.80 | $26.92 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $6.92 | $13.49 | $27.54 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $147.91 Median $602.56 Typical High $2,754.23 | Facility | 50 · Both sides | $147.91 | $602.56 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $316.23 Typical High $389.05 | Professional | 50 · Both sides | $138.04 | $316.23 | $389.05 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $109.65 Median $257.04 Typical High $316.23 | Professional | 63 · Small infant | $109.65 | $257.04 | $316.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $67.61 Typical High $134.90 | Professional | 52 · Reduced service | $37.15 | $67.61 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $26.92 Typical High $54.95 | Professional | 53 · Discontinued | $14.79 | $26.92 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $7.41 | $13.49 | $27.54 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $204.17 Typical High $407.38 | Professional | 50 · Both sides | $204.17 | $204.17 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $27.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $204.17 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 19th of 51
$135
AK $263VA $81.28
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.