How much rates vary
Facilitymedian $204 · 10th to 90th $76 to $417Professionalmedian $100 · 10th to 90th $62 to $170
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 $100.00 Median $169.82 Typical High $4,466.84 | Facility | None | $100.00 | $169.82 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $144.54 | Professional | None | $54.95 | $95.50 | $144.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $204.17 Typical High $389.05 | Facility | None | $48.98 | $204.17 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $177.83 | Professional | None | $72.44 | $123.03 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $169.82 Typical High $537.03 | Facility | None | $75.86 | $169.82 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $208.93 | Professional | None | $66.07 | $120.23 | $208.93 |
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 $147.91 | Facility | None | $75.86 | $75.86 | $147.91 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $158.49 | Professional | None | $70.79 | $138.04 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $416.87 | Facility | None | $218.78 | $331.13 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $131.83 | Professional | None | $72.44 | $95.50 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $77.62 Typical High $134.90 | Facility | None | $75.86 | $77.62 | $134.90 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $102.33 | Professional | None | $51.29 | $75.86 | $102.33 |
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 $51.29 Median $100.00 Typical High $181.97 | Professional | None | $51.29 | $100.00 | $181.97 |
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 $30.20 Median $41.69 Typical High $70.79 | Professional | 52 · Reduced service | $30.20 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $28.18 | Professional | 53 · Discontinued | $12.02 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $107.15 | Professional | 54 · Surgery only | $45.71 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $21.38 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $14.13 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $67.61 Median $257.04 Typical High $407.38 | Facility | 50 · Both sides | $67.61 | $257.04 | $407.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $131.83 Typical High $269.15 | Professional | 50 · Both sides | $112.20 | $131.83 | $269.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $81.28 Typical High $154.88 | Professional | 54 · Surgery only | $67.61 | $81.28 | $154.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.12 Typical High $17.38 | Professional | 55 · Aftercare only | $7.59 | $9.12 | $17.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $93.33 Median $162.18 Typical High $208.93 | Professional | 63 · Small infant | $93.33 | $162.18 | $208.93 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $81.28 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $52.48 | $81.28 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $30.20 | $54.95 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $28.18 | Professional | 53 · Discontinued | $12.02 | $16.60 | $28.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $107.15 | Professional | 54 · Surgery only | $45.71 | $63.10 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $21.38 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $14.13 |
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· 12th of 51
$115
AK $214KY $64.57
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.