How much rates vary
Facilitymedian $550 · 10th to 90th $129 to $3,890Professionalmedian $138 · 10th to 90th $81 to $263
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 $66.07 Median $120.23 Typical High $257.04 | Professional | None | $66.07 | $120.23 | $257.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $1,348.96 Typical High $3,981.07 | Facility | None | $147.91 | $1,348.96 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $302.00 | Professional | None | $97.72 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $190.55 | Facility | None | $123.03 | $138.04 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $229.09 | Professional | None | $85.11 | $158.49 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $158.49 Typical High $4,466.84 | Facility | None | $70.79 | $158.49 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $257.04 | Professional | None | $89.13 | $151.36 | $257.04 |
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 $104.71 Median $104.71 Typical High $257.04 | Facility | None | $104.71 | $104.71 | $257.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $275.42 | Professional | None | $97.72 | $208.93 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $239.88 | Professional | None | $97.72 | $128.82 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $2,754.23 | Facility | None | $131.83 | $134.90 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $177.83 | Professional | None | $70.79 | $131.83 | $177.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $263.03 | Professional | None | $67.61 | $131.83 | $263.03 |
16 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 $40.74 Median $54.95 Typical High $128.82 | Professional | 52 · Reduced service | $40.74 | $54.95 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.39 Typical High $51.29 | Professional | 53 · Discontinued | $16.22 | $22.39 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $194.98 | Professional | 54 · Surgery only | $61.66 | $83.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $38.90 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $25.70 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $223.87 Median $1,905.46 Typical High $6,025.60 | Facility | 50 · Both sides | $223.87 | $1,905.46 | $6,025.60 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $354.81 Typical High $537.03 | Professional | 50 · Both sides | $158.49 | $354.81 | $537.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $112.20 Typical High $275.42 | Professional | 54 · Surgery only | $93.33 | $112.20 | $275.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.85 Typical High $30.20 | Professional | 55 · Aftercare only | $10.23 | $15.85 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $123.03 Median $144.54 Typical High $363.08 | Professional | 63 · Small infant | $123.03 | $144.54 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $74.13 | $147.91 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $54.95 Typical High $128.82 | Professional | 52 · Reduced service | $40.74 | $54.95 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.39 Typical High $51.29 | Professional | 53 · Discontinued | $16.22 | $22.39 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $194.98 | Professional | 54 · Surgery only | $61.66 | $83.18 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $38.90 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $25.70 |
Where Idaho sits
The same service costs 5.9 times more in Oklahoma 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· 13th of 51
$166
OK $468KY $79.43
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.