How much rates vary
Facilitymedian $145 · 10th to 90th $72 to $257Professionalmedian $126 · 10th to 90th $102 to $166
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 $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $173.78 Typical High $316.23 | Facility | None | $134.90 | $173.78 | $316.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $165.96 | Professional | None | $120.23 | $147.91 | $165.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | None | $107.15 | $128.82 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $177.83 | Facility | None | $112.20 | $123.03 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $151.36 | Professional | None | $112.20 | $123.03 | $151.36 |
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 $125.89 Median $138.04 Typical High $138.04 | Facility | None | $125.89 | $138.04 | $138.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | None | $123.03 | $138.04 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $93.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $165.96 | Professional | None | $102.33 | $120.23 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $75.86 | Facility | None | $58.88 | $72.44 | $75.86 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $144.54 | Professional | None | $72.44 | $72.44 | $144.54 |
United Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $169.82 | Professional | None | $93.33 | $123.03 | $169.82 |
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 $47.86 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $47.86 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $19.05 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.60 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $12.30 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 22 · Increased work | $134.90 | $134.90 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $87.10 | $87.10 | $87.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 63 · Small infant | $134.90 | $134.90 | $134.90 |
Where Idaho sits
The same service costs 3.1 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· 14th of 51
$129
AK $229FL $74.13
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.