How much rates vary
Facilitymedian $407 · 10th to 90th $234 to $562Professionalmedian $417 · 10th to 90th $257 to $646
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $245.47 Median $407.38 Typical High $407.38 | Professional | None | $245.47 | $407.38 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $457.09 | Facility | None | $234.42 | $354.81 | $457.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $676.08 | Professional | None | $407.38 | $575.44 | $676.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $489.78 | Professional | None | $338.84 | $426.58 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $407.38 Typical High $588.84 | Facility | None | $380.19 | $407.38 | $588.84 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $537.03 | Professional | None | $257.04 | $407.38 | $537.03 |
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 $501.19 Median $562.34 Typical High $562.34 | Facility | None | $501.19 | $562.34 | $562.34 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | None | $416.87 | $562.34 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $501.19 | Professional | None | $346.74 | $407.38 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $302.00 | Facility | None | $234.42 | $295.12 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $478.63 | Professional | None | $295.12 | $295.12 | $478.63 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $457.09 | Professional | None | $257.04 | $323.59 | $457.09 |
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 $144.54 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $43.65 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $40.74 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 22 · Increased work | $457.09 | $457.09 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 63 · Small infant | $457.09 | $457.09 | $457.09 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in New York. 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
$417
AK $661NY $234
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.