How much rates vary
Facilitymedian $162 · 10th to 90th $91 to $708Professionalmedian $98 · 10th to 90th $69 to $129
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 $77.62 Median $112.20 Typical High $128.82 | Professional | None | $77.62 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $58.88 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $11.75 | $16.98 | $19.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $316.23 | Facility | None | $128.82 | $199.53 | $316.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | None | $87.10 | $102.33 | $120.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $93.33 Typical High $109.65 | Professional | 54 · Surgery only | $77.62 | $93.33 | $109.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $102.33 | Professional | None | $67.61 | $85.11 | $102.33 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | None | $234.42 | $234.42 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $5,495.41 | Facility | None | $93.33 | $128.82 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $128.82 | Professional | None | $79.43 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $60.26 | $85.11 | $95.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $12.02 | $16.98 | $19.50 |
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 $91.20 Median $91.20 Typical High $112.20 | Facility | None | $91.20 | $91.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $128.82 | Professional | None | $79.43 | $97.72 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $114.82 | Professional | None | $85.11 | $102.33 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $138.04 | Facility | None | $52.48 | $53.70 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $109.65 | Professional | None | $52.48 | $74.13 | $109.65 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $120.23 | Professional | None | $57.54 | $81.28 | $120.23 |
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 $38.90 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $38.90 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $15.49 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.76 | $11.22 | $12.88 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $199.53 Median $295.12 Typical High $467.74 | Facility | 50 · Both sides | $199.53 | $295.12 | $467.74 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $154.88 Typical High $181.97 | Professional | 50 · Both sides | $125.89 | $154.88 | $181.97 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $125.89 Typical High $147.91 | Professional | 63 · Small infant | $102.33 | $125.89 | $147.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $69.18 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $58.88 | $69.18 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $39.81 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $15.85 | $22.39 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.94 | $11.22 | $12.88 |
Where Idaho sits
The same service costs 3.4 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· 11th of 51
$100
AK $182FL $53.70
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.