How much rates vary
Facilitymedian $27 · 10th to 90th $17 to $35Professionalmedian $26 · 10th to 90th $23 to $39
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 $19.05 Median $24.55 Typical High $24.55 | Professional | None | $19.05 | $24.55 | $24.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.78 Median $27.54 Typical High $35.48 | Facility | None | $17.78 | $27.54 | $35.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $24.55 Median $34.67 Typical High $39.81 | Professional | None | $24.55 | $34.67 | $39.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $17.38 Median $26.30 Typical High $28.84 | Professional | 78 · Unplanned return to OR | $17.38 | $26.30 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $26.30 Typical High $30.90 | Professional | None | $21.38 | $26.30 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $22.91 Median $24.55 Typical High $35.48 | Facility | None | $22.91 | $24.55 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $32.36 | Professional | None | $22.91 | $24.55 | $32.36 |
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 $30.20 Median $33.11 Typical High $33.11 | Facility | None | $30.20 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $33.11 | Professional | None | $24.55 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 78 · Unplanned return to OR | $18.62 | $18.62 | $18.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $33.11 | Professional | None | $20.89 | $24.55 | $33.11 |
Select Health Setting Facility Modifier None Typical Low $14.13 Median $17.38 Typical High $17.78 | Facility | None | $14.13 | $17.38 | $17.78 |
Select Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $28.84 | Professional | None | $17.38 | $17.38 | $28.84 |
United Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $33.88 | Professional | None | $19.05 | $24.55 | $33.88 |
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 $9.55 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $9.55 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $3.80 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $2.88 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.91 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $10.96 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.37 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.19 | $2.45 | $2.45 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 22 · Increased work | $26.92 | $26.92 | $26.92 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 54 · Surgery only | $17.38 | $17.38 | $17.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 63 · Small infant | $26.92 | $26.92 | $26.92 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in Florida. 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
$26.30
AK $50.12FL $14.79
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.