How much rates vary
Facilitymedian $170 · 10th to 90th $32 to $851Professionalmedian $91 · 10th to 90th $66 to $117
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 $61.66 Median $102.33 Typical High $147.91 | Professional | None | $61.66 | $102.33 | $147.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $32.36 Median $281.84 Typical High $758.58 | Facility | None | $32.36 | $281.84 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $117.49 | Professional | None | $72.44 | $93.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $31.62 Typical High $42.66 | Facility | None | $28.18 | $31.62 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | None | $66.07 | $74.13 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $5,495.41 | Facility | None | $48.98 | $102.33 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $112.20 | Professional | None | $61.66 | $87.10 | $112.20 |
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 $75.86 Median $75.86 Typical High $102.33 | Facility | None | $75.86 | $75.86 | $102.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $128.82 | Professional | None | $66.07 | $89.13 | $128.82 |
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 $79.43 Median $93.33 Typical High $102.33 | Professional | None | $79.43 | $93.33 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $50.12 Typical High $724.44 | Facility | None | $48.98 | $50.12 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $48.98 Typical High $85.11 | Professional | None | $22.91 | $48.98 | $85.11 |
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 $63.10 Median $104.71 Typical High $165.96 | Professional | None | $63.10 | $104.71 | $165.96 |
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 $38.90 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $38.90 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $15.49 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $57.54 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $11.22 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $48.98 Median $426.58 Typical High $1,148.15 | Facility | 50 · Both sides | $48.98 | $426.58 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $128.82 Typical High $173.78 | Professional | 50 · Both sides | $104.71 | $128.82 | $173.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $97.72 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $97.72 | $104.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.32 Typical High $11.75 | Professional | 55 · Aftercare only | $7.08 | $8.32 | $11.75 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $87.10 Median $112.20 Typical High $154.88 | Professional | 63 · Small infant | $87.10 | $112.20 | $154.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $67.61 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $48.98 | $67.61 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $38.90 | $51.29 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $15.49 | $20.42 | $22.39 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $57.54 | $75.86 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $11.22 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 50 · Both sides | $173.78 | $173.78 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $81.28 | $81.28 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $95.50 |
Where Idaho sits
The same service costs 3.6 times more in Wyoming 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· 13th of 51
$93.33
WY $191FL $52.48
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.