How much rates vary
Facilitymedian $151 · 10th to 90th $89 to $240Professionalmedian $93 · 10th to 90th $65 to $166
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 $75.86 Median $93.33 Typical High $158.49 | Professional | None | $75.86 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $46.77 Typical High $79.43 | Professional | 52 · Reduced service | $38.02 | $46.77 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.62 Typical High $31.62 | Professional | 53 · Discontinued | $15.14 | $18.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $23.99 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.33 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.59 | $9.33 | $15.85 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Facility | None | $147.91 | $204.17 | $288.40 |
BCBS Idaho Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $151.36 | Professional | None | $75.86 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $144.54 | Professional | None | $46.77 | $75.86 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $158.49 | Facility | None | $75.86 | $102.33 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $165.96 | Professional | None | $83.18 | $97.72 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $46.77 Typical High $79.43 | Professional | 52 · Reduced service | $38.02 | $46.77 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.62 Typical High $31.62 | Professional | 53 · Discontinued | $15.14 | $18.62 | $31.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $23.99 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.33 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.59 | $9.33 | $15.85 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $177.83 | Facility | None | $89.13 | $89.13 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $177.83 | Professional | None | $85.11 | $89.13 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $14.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $239.88 | Facility | None | $147.91 | $158.49 | $239.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $165.96 | Professional | None | $75.86 | $107.15 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $97.72 | Facility | None | $95.50 | $95.50 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $104.71 | Professional | None | $58.88 | $89.13 | $104.71 |
United Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $125.89 | Professional | None | $30.20 | $74.13 | $125.89 |
4 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $100.00 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $74.13 | $100.00 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $102.33 | Professional | 54 · Surgery only | $58.88 | $58.88 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $63.10 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $63.10 | $63.10 | $109.65 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Idaho sits
The same service costs 3.0 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· 12th of 51
$93.33
AK $166FL $54.95
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.