How much rates vary
Facilitymedian $135 · 10th to 90th $41 to $759Professionalmedian $93 · 10th to 90th $63 to $135
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 $93.33 Median $104.71 Typical High $134.90 | Professional | None | $93.33 | $104.71 | $134.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $44.67 Median $134.90 Typical High $891.25 | Facility | None | $44.67 | $134.90 | $891.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $138.04 | Professional | None | $75.86 | $112.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $54.95 | Facility | None | $36.31 | $40.74 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $97.72 | Professional | None | $48.98 | $77.62 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $4,466.84 | Facility | None | $58.88 | $134.90 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $134.90 | Professional | None | $69.18 | $104.71 | $134.90 |
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 $79.43 Median $79.43 Typical High $123.03 | Facility | None | $79.43 | $79.43 | $123.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $154.88 | Professional | None | $69.18 | $107.15 | $154.88 |
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 $100.00 Typical High $123.03 | Professional | None | $79.43 | $100.00 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $60.26 Typical High $426.58 | Facility | None | $58.88 | $60.26 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $89.13 | Professional | None | $29.51 | $58.88 | $89.13 |
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 $53.70 Median $77.62 Typical High $114.82 | Professional | None | $53.70 | $77.62 | $114.82 |
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 $46.77 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $10.47 | $13.49 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $66.07 Median $181.97 Typical High $1,318.26 | Facility | 50 · Both sides | $66.07 | $181.97 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $134.90 Typical High $177.83 | Professional | 50 · Both sides | $112.20 | $134.90 | $177.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $66.07 | $104.71 | $123.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $7.41 | $11.75 | $13.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $89.13 Median $141.25 Typical High $165.96 | Professional | 63 · Small infant | $89.13 | $141.25 | $165.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $63.10 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $53.70 | $63.10 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $52.48 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $77.62 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $15.85 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $10.47 | $13.49 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | 50 · Both sides | $177.83 | $177.83 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $83.18 | $83.18 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $15.49 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $117.49 |
Where Idaho sits
The same service costs 3.7 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· 9th of 51
$97.72
AK $191FL $51.29
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.