How much rates vary
Facilitymedian $263 · 10th to 90th $98 to $661Professionalmedian $145 · 10th to 90th $85 to $288
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $229.09 | Professional | None | $81.28 | $169.82 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $602.56 | Facility | None | $134.90 | $281.84 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $316.23 | Professional | None | $89.13 | $218.78 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $281.84 | Professional | None | $95.50 | $147.91 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $229.09 Typical High $5,495.41 | Facility | None | $93.33 | $229.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $309.03 | Professional | None | $77.62 | $177.83 | $309.03 |
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 $85.11 Median $85.11 Typical High $263.03 | Facility | None | $85.11 | $85.11 | $263.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $269.15 | Professional | None | $85.11 | $173.78 | $269.15 |
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 $107.15 Median $158.49 Typical High $309.03 | Professional | None | $107.15 | $158.49 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $281.84 | Facility | None | $138.04 | $141.25 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
United Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $281.84 | Professional | None | $77.62 | $144.54 | $281.84 |
14 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 $48.98 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $48.98 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $19.95 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $74.13 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $14.79 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.77 | $18.20 | $22.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $79.43 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $63.10 | $79.43 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $114.82 | Professional | 52 · Reduced service | $48.98 | $48.98 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $46.77 | Professional | 53 · Discontinued | $19.95 | $19.95 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $173.78 | Professional | 54 · Surgery only | $74.13 | $74.13 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $34.67 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $22.91 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $186.21 | Professional | 54 · Surgery only | $79.43 | $79.43 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $26.92 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $199.53 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 9th of 51
$191
AK $288MD $83.18
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.