How much rates vary
Facilitymedian $170 · 10th to 90th $76 to $646Professionalmedian $100 · 10th to 90th $60 to $182
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 $47.86 Median $95.50 Typical High $169.82 | Professional | None | $47.86 | $95.50 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $87.10 Median $288.40 Typical High $630.96 | Facility | None | $87.10 | $288.40 | $630.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $194.98 | Professional | None | $69.18 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $107.15 | Facility | None | $70.79 | $79.43 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $154.88 | Professional | None | $66.07 | $109.65 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $117.49 Typical High $4,466.84 | Facility | None | $53.70 | $117.49 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $169.82 | Professional | None | $60.26 | $97.72 | $169.82 |
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 $69.18 Median $69.18 Typical High $165.96 | Facility | None | $69.18 | $69.18 | $165.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $177.83 | Professional | None | $64.57 | $151.36 | $177.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $794.33 | Facility | None | $407.38 | $588.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $162.18 | Professional | None | $70.79 | $93.33 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $549.54 | Facility | None | $87.10 | $87.10 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $120.23 | Professional | None | $46.77 | $87.10 | $120.23 |
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 $52.48 Median $100.00 Typical High $181.97 | Professional | None | $52.48 | $100.00 | $181.97 |
14 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 $30.20 Median $41.69 Typical High $85.11 | Professional | 52 · Reduced service | $30.20 | $41.69 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $34.67 | Professional | 53 · Discontinued | $12.02 | $16.60 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $61.66 Typical High $128.82 | Professional | 54 · Surgery only | $44.67 | $61.66 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $25.70 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $16.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $72.44 Typical High $181.97 | Professional | 54 · Surgery only | $61.66 | $72.44 | $181.97 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $20.42 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $20.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $83.18 Median $100.00 Typical High $245.47 | Professional | 63 · Small infant | $83.18 | $100.00 | $245.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $56.23 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $47.86 | $56.23 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $41.69 Typical High $85.11 | Professional | 52 · Reduced service | $30.20 | $41.69 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $34.67 | Professional | 53 · Discontinued | $12.02 | $16.60 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $61.66 Typical High $128.82 | Professional | 54 · Surgery only | $44.67 | $61.66 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $25.70 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $16.98 |
Where Idaho sits
The same service costs 3.3 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· 16th of 51
$110
AK $204KY $61.66
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.