How much rates vary
Facilitymedian $62 · 10th to 90th $35 to $95Professionalmedian $38 · 10th to 90th $30 to $66
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 $30.90 Median $37.15 Typical High $61.66 | Professional | None | $30.90 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $18.62 Typical High $30.20 | Professional | 52 · Reduced service | $15.49 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.41 Typical High $12.30 | Professional | 53 · Discontinued | $6.17 | $7.41 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.62 Typical High $9.12 | Professional | 55 · Aftercare only | $4.57 | $5.62 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.72 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.09 | $3.72 | $6.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $144.54 | Facility | None | $58.88 | $70.79 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $30.20 Median $53.70 Typical High $60.26 | Professional | None | $30.20 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $31.62 Typical High $54.95 | Professional | None | $19.05 | $31.62 | $54.95 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $52.48 Typical High $61.66 | Facility | None | $30.90 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $66.07 | Professional | None | $30.90 | $39.81 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $18.62 Typical High $30.20 | Professional | 52 · Reduced service | $15.49 | $18.62 | $30.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.41 Typical High $12.30 | Professional | 53 · Discontinued | $6.17 | $7.41 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.62 Typical High $9.12 | Professional | 55 · Aftercare only | $4.57 | $5.62 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.72 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.09 | $3.72 | $6.17 |
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 $35.48 Median $35.48 Typical High $72.44 | Facility | None | $35.48 | $35.48 | $72.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $34.67 Median $35.48 Typical High $72.44 | Professional | None | $34.67 | $35.48 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $5.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $58.88 Median $63.10 Typical High $95.50 | Facility | None | $58.88 | $63.10 | $95.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $66.07 | Professional | None | $30.20 | $43.65 | $66.07 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.90 | Facility | None | $38.02 | $38.02 | $38.90 |
Select Health Setting Professional Modifier None Typical Low $23.44 Median $35.48 Typical High $41.69 | Professional | None | $23.44 | $35.48 | $41.69 |
United Setting Professional Modifier None Typical Low $21.88 Median $34.67 Typical High $56.23 | Professional | None | $21.88 | $34.67 | $56.23 |
3 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 $29.51 Median $40.74 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $29.51 | $40.74 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $40.74 | Professional | 54 · Surgery only | $23.44 | $23.44 | $40.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.12 Median $25.12 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $25.12 | $25.12 | $43.65 |
Where Idaho sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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
$38.02
AK $67.61NJ $25.12
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.