How much rates vary
Facilitymedian $331 · 10th to 90th $135 to $603Professionalmedian $209 · 10th to 90th $158 to $257
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $208.93 | Professional | None | $151.36 | $190.55 | $208.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $323.59 Typical High $602.56 | Facility | None | $134.90 | $323.59 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $269.15 | Professional | None | $204.17 | $229.09 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $218.78 | Professional | None | $154.88 | $194.98 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $190.55 Typical High $5,495.41 | Facility | None | $40.74 | $190.55 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $245.47 | Professional | None | $190.55 | $213.80 | $245.47 |
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 $204.17 Median $229.09 Typical High $229.09 | Facility | None | $204.17 | $229.09 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | None | $208.93 | $229.09 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | None | $204.17 | $204.17 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $120.23 Typical High $281.84 | Facility | None | $117.49 | $120.23 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $165.96 | Professional | None | $117.49 | $117.49 | $165.96 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $234.42 | Professional | None | $134.90 | $177.83 | $234.42 |
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 $93.33 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 54 · Surgery only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $147.91 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Idaho sits
The same service costs 3.2 times more in Alaska 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· 13th of 51
$214
AK $347KY $107
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.