How much rates vary
Facilitymedian $251 · 10th to 90th $76 to $631Professionalmedian $98 · 10th to 90th $66 to $162
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 $52.48 Median $91.20 Typical High $138.04 | Professional | None | $52.48 | $91.20 | $138.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $316.23 Typical High $602.56 | Facility | None | $66.07 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $165.96 | Professional | None | $79.43 | $120.23 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $123.03 | Professional | None | $70.79 | $89.13 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $4,466.84 | Facility | None | $66.07 | $128.82 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $158.49 | Professional | None | $69.18 | $107.15 | $158.49 |
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 $79.43 Median $79.43 Typical High $141.25 | Facility | None | $79.43 | $79.43 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $169.82 | Professional | None | $75.86 | $131.83 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $128.82 | Professional | None | $79.43 | $102.33 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $194.98 | Facility | None | $72.44 | $74.13 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $100.00 | Professional | None | $54.95 | $72.44 | $100.00 |
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 $56.23 Median $104.71 Typical High $204.17 | Professional | None | $56.23 | $104.71 | $204.17 |
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 $33.11 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $33.11 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.20 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | 54 · Surgery only | $48.98 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $20.42 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.61 | $9.12 | $13.80 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $100.00 Median $467.74 Typical High $933.25 | Facility | 50 · Both sides | $100.00 | $467.74 | $933.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $144.54 Typical High $257.04 | Professional | 50 · Both sides | $120.23 | $144.54 | $257.04 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $74.13 | $125.89 | $154.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $7.94 | $14.13 | $16.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $95.50 Median $165.96 Typical High $199.53 | Professional | 63 · Small infant | $95.50 | $165.96 | $199.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $81.28 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $56.23 | $81.28 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $33.11 | $44.67 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.20 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $18.20 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | 54 · Surgery only | $48.98 | $67.61 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $20.42 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.61 | $9.12 | $13.80 |
Where Idaho sits
The same service costs 3.2 times more in Wisconsin 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· 19th of 51
$110
WI $229KY $72.44
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.