How much rates vary
Facilitymedian $141 · 10th to 90th $28 to $708Professionalmedian $26 · 10th to 90th $16 to $38
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 $29.51 Median $32.36 Typical High $5,495.41 | Facility | None | $29.51 | $32.36 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $25.70 Typical High $30.90 | Professional | None | $13.18 | $25.70 | $30.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $199.53 | Facility | None | $72.44 | $114.82 | $199.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $36.31 | Professional | None | $24.55 | $30.20 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $23.99 | Professional | None | $17.78 | $22.39 | $23.99 |
Moda Health Setting Facility Modifier None Typical Low $15.49 Median $52.48 Typical High $851.14 | Facility | None | $15.49 | $52.48 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $14.45 Median $25.70 Typical High $66.07 | Professional | None | $14.45 | $25.70 | $66.07 |
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 $26.30 Median $30.20 Typical High $30.20 | Facility | None | $26.30 | $30.20 | $30.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $51.29 | Professional | None | $28.18 | $30.20 | $51.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Facility | None | $107.15 | $154.88 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $25.12 | Professional | None | $23.44 | $24.55 | $25.12 |
Select Health Setting Facility Modifier None Typical Low $15.49 Median $15.85 Typical High $97.72 | Facility | None | $15.49 | $15.85 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
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 $13.49 Median $18.20 Typical High $26.30 | Professional | None | $13.49 | $18.20 | $26.30 |
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 $7.76 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $7.76 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $3.09 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $19.50 Typical High $19.50 | Professional | 54 · Surgery only | $11.48 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $2.29 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.55 | $2.57 | $2.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | 50 · Both sides | $43.65 | $50.12 | $57.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $30.20 Typical High $33.11 | Professional | 54 · Surgery only | $26.30 | $30.20 | $33.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.39 Typical High $3.63 | Professional | 55 · Aftercare only | $2.95 | $3.39 | $3.63 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $35.48 Median $40.74 Typical High $43.65 | Professional | 63 · Small infant | $35.48 | $40.74 | $43.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $23.44 Typical High $25.70 | Professional | 78 · Unplanned return to OR | $20.42 | $23.44 | $25.70 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $17.78 Median $37.15 Typical High $107.15 | Professional | 50 · Both sides | $17.78 | $37.15 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $10.72 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $4.27 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | 54 · Surgery only | $16.22 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.24 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.14 | $2.57 | $2.57 |
Where Idaho sits
The same service costs 7.4 times more in Kansas 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· 17th of 51
$28.18
KS $95.50KY $12.88
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.