How much rates vary
Facilitymedian $204 · 10th to 90th $59 to $603Professionalmedian $68 · 10th to 90th $35 to $166
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 $57.54 Median $158.49 Typical High $4,466.84 | Facility | None | $57.54 | $158.49 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $154.88 | Professional | None | $44.67 | $77.62 | $154.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $257.04 Typical High $602.56 | Facility | None | $112.20 | $257.04 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $38.02 Median $107.15 Typical High $213.80 | Professional | None | $38.02 | $107.15 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $93.33 | Professional | None | $34.67 | $46.77 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $194.98 Typical High $891.25 | Facility | None | $50.12 | $194.98 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $165.96 | Professional | None | $50.12 | $61.66 | $165.96 |
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 $35.48 Median $51.29 Typical High $112.20 | Facility | None | $35.48 | $51.29 | $112.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $147.91 | Professional | None | $35.48 | $46.77 | $147.91 |
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 $38.02 Median $77.62 Typical High $144.54 | Professional | None | $38.02 | $77.62 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $354.81 | Facility | None | $95.50 | $95.50 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | None | $95.50 | $95.50 | $125.89 |
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 $23.99 Median $57.54 Typical High $100.00 | Professional | None | $23.99 | $57.54 | $100.00 |
10 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 54 · Surgery only Typical Low $37.15 Median $74.13 Typical High $102.33 | Professional | 54 · Surgery only | $37.15 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $14.79 Typical High $20.42 | Professional | 55 · Aftercare only | $7.41 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.01 | $9.77 | $13.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $45.71 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $28.18 | $45.71 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $45.71 Typical High $102.33 | Professional | 54 · Surgery only | $37.15 | $45.71 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.12 Typical High $20.42 | Professional | 55 · Aftercare only | $7.41 | $9.12 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.03 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.01 | $6.03 | $13.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.18 Typical High $79.43 | Professional | 54 · Surgery only | $28.18 | $28.18 | $79.43 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $11.22 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $30.20 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $30.20 | $30.20 | $85.11 |
Where Idaho sits
The same service costs 2.8 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· 12th of 51
$93.33
AK $141KY $51.29
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.