How much rates vary
Facilitymedian $363 · 10th to 90th $126 to $2,089Professionalmedian $275 · 10th to 90th $182 to $427
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 $162.18 Median $316.23 Typical High $426.58 | Professional | None | $162.18 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $234.42 Typical High $323.59 | Professional | 54 · Surgery only | $123.03 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $24.55 | $47.86 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $245.47 Typical High $2,089.30 | Facility | None | $128.82 | $245.47 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $389.05 | Professional | None | $204.17 | $316.23 | $389.05 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $354.81 | Professional | 54 · Surgery only | $181.97 | $223.87 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $20.42 | $33.11 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $128.82 Typical High $173.78 | Facility | None | $114.82 | $128.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $275.42 | Professional | None | $181.97 | $213.80 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $426.58 Typical High $5,495.41 | Facility | None | $162.18 | $426.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $426.58 | Professional | None | $190.55 | $316.23 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $234.42 Typical High $323.59 | Professional | 54 · Surgery only | $123.03 | $234.42 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $24.55 | $47.86 | $64.57 |
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 $218.78 Median $218.78 Typical High $363.08 | Facility | None | $218.78 | $218.78 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | 54 · Surgery only | $223.87 | $223.87 | $309.03 |
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 $269.15 Median $309.03 Typical High $426.58 | Professional | None | $269.15 | $309.03 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $223.87 | Professional | None | $117.49 | $173.78 | $223.87 |
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 $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
10 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 $81.28 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $81.28 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $63.10 Typical High $87.10 | Professional | 53 · Discontinued | $33.11 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $16.22 | $31.62 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $407.38 Typical High $489.78 | Professional | 63 · Small infant | $245.47 | $407.38 | $489.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $173.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $141.25 | $173.78 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $81.28 | $158.49 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $63.10 Typical High $87.10 | Professional | 53 · Discontinued | $33.11 | $63.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $16.22 | $31.62 | $42.66 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $331.13 |
Where Idaho sits
The same service costs 3.6 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
$275
AK $537KY $148
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.