How much rates vary
Facilitymedian $166 · 10th to 90th $46 to $759Professionalmedian $126 · 10th to 90th $79 to $166
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 $75.86 Median $138.04 Typical High $165.96 | Professional | None | $75.86 | $138.04 | $165.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $45.71 Median $302.00 Typical High $758.58 | Facility | None | $45.71 | $302.00 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $173.78 | Professional | None | $104.71 | $144.54 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | None | $41.69 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $120.23 | Professional | None | $61.66 | $100.00 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $138.04 Typical High $4,466.84 | Facility | None | $53.70 | $138.04 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $165.96 | Professional | None | $91.20 | $128.82 | $165.96 |
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 $109.65 Median $109.65 Typical High $154.88 | Facility | None | $109.65 | $109.65 | $154.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $194.98 | Professional | None | $95.50 | $134.90 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $954.99 | Facility | None | $501.19 | $758.58 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | None | $107.15 | $128.82 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $724.44 | Facility | None | $74.13 | $75.86 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $74.13 Typical High $117.49 | Professional | None | $33.88 | $74.13 | $117.49 |
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 $66.07 Median $97.72 Typical High $141.25 | Professional | None | $66.07 | $97.72 | $141.25 |
20 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 $56.23 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $16.60 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $69.18 Median $446.68 Typical High $1,148.15 | Facility | 50 · Both sides | $69.18 | $446.68 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $186.21 Typical High $288.40 | Professional | 50 · Both sides | $147.91 | $186.21 | $288.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $91.20 | $112.20 | $144.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $19.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $125.89 Median $169.82 Typical High $204.17 | Professional | 63 · Small infant | $125.89 | $169.82 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $87.10 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $70.79 | $87.10 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $69.18 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $27.54 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $102.33 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $16.60 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 50 · Both sides | $239.88 | $239.88 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $112.20 | $112.20 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $144.54 |
Where Idaho sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$126
AK $257FL $67.61
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.