How much rates vary
Facilitymedian $275 · 10th to 90th $98 to $437Professionalmedian $158 · 10th to 90th $83 to $363
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 Facility Modifier None Typical Low $109.65 Median $309.03 Typical High $5,495.41 | Facility | None | $109.65 | $309.03 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $257.04 | Professional | None | $70.79 | $169.82 | $257.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $426.58 | Facility | None | $125.89 | $263.03 | $426.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $426.58 | Professional | None | $97.72 | $123.03 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $309.03 | Professional | None | $89.13 | $177.83 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | None | $489.78 | $489.78 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $173.78 Typical High $371.54 | Facility | None | $85.11 | $173.78 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $346.74 | Professional | None | $85.11 | $173.78 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $79.43 | Professional | None | $33.11 | $33.11 | $79.43 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $354.81 | Facility | None | $97.72 | $97.72 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $354.81 | Professional | None | $95.50 | $104.71 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $478.63 | Facility | None | $295.12 | $316.23 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $323.59 | Professional | None | $97.72 | $169.82 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $309.03 | Facility | None | $186.21 | $190.55 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $288.40 | Professional | None | $87.10 | $186.21 | $288.40 |
United Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $309.03 | Professional | None | $74.13 | $162.18 | $309.03 |
11 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 $42.66 Median $45.71 Typical High $128.82 | Professional | 52 · Reduced service | $42.66 | $45.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $51.29 | Professional | 53 · Discontinued | $16.98 | $18.62 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $69.18 Typical High $194.98 | Professional | 54 · Surgery only | $63.10 | $69.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $38.90 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $25.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $128.82 | Professional | 52 · Reduced service | $45.71 | $45.71 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $51.29 | Professional | 53 · Discontinued | $18.62 | $18.62 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $194.98 | Professional | 54 · Surgery only | $69.18 | $69.18 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $38.90 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $25.70 |
Where Idaho sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 20th of 51
$182
WA $288KY $100
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.