How much rates vary
Facilitymedian $200 · 10th to 90th $102 to $324Professionalmedian $170 · 10th to 90th $132 to $234
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 Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | None | $117.49 | $169.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $398.11 | Facility | None | $186.21 | $239.88 | $398.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | None | $144.54 | $177.83 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $169.82 Typical High $245.47 | Facility | None | $144.54 | $169.82 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $208.93 | Professional | None | $128.82 | $169.82 | $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 $173.78 Median $190.55 Typical High $190.55 | Facility | None | $173.78 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | None | $169.82 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $229.09 | Professional | None | $144.54 | $169.82 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $104.71 | Facility | None | $81.28 | $102.33 | $104.71 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $199.53 | Professional | None | $102.33 | $102.33 | $199.53 |
United Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $239.88 | Professional | None | $128.82 | $169.82 | $239.88 |
12 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 $64.57 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $25.70 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.88 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $75.86 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 22 · Increased work | $190.55 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 63 · Small infant | $190.55 | $190.55 | $190.55 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$174
AK $316UT $97.72
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.