How much rates vary
Facilitymedian $132 · 10th to 90th $72 to $263Professionalmedian $110 · 10th to 90th $87 to $155
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 $91.20 Median $102.33 Typical High $104.71 | Professional | None | $91.20 | $102.33 | $104.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $263.03 | Facility | None | $75.86 | $141.25 | $263.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $158.49 | Professional | None | $109.65 | $134.90 | $158.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $104.71 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $77.62 | $104.71 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $128.82 | Professional | None | $87.10 | $109.65 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $147.91 | Facility | None | $102.33 | $104.71 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | None | $102.33 | $102.33 | $131.83 |
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 $117.49 Median $131.83 Typical High $131.83 | Facility | None | $117.49 | $131.83 | $131.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $134.90 | Professional | None | $109.65 | $131.83 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $154.88 | Facility | None | $77.62 | $120.23 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | None | $91.20 | $109.65 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $323.59 | Facility | None | $69.18 | $70.79 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $123.03 | Professional | None | $69.18 | $87.10 | $123.03 |
United Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $141.25 | Professional | None | $79.43 | $104.71 | $141.25 |
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 $45.71 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $45.71 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $20.89 | Professional | 53 · Discontinued | $18.20 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $51.29 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.47 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 22 · Increased work | $123.03 | $123.03 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 54 · Surgery only | $77.62 | $77.62 | $77.62 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 63 · Small infant | $123.03 | $123.03 | $123.03 |
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· 16th of 51
$110
AK $195FL $64.57
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.