How much rates vary
Facilitymedian $251 · 10th to 90th $20 to $417Professionalmedian $29 · 10th to 90th $17 to $38
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $19.50 Median $23.99 Typical High $26.92 | Professional | None | $19.50 | $23.99 | $26.92 |
BCBS Idaho Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $436.52 | Facility | None | $208.93 | $295.12 | $436.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $44.67 | Professional | None | $25.12 | $29.51 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $28.84 | Professional | None | $16.98 | $23.44 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $181.97 | Facility | None | $23.99 | $23.99 | $181.97 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $38.02 | Professional | None | $23.99 | $25.12 | $38.02 |
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 $33.88 Median $37.15 Typical High $37.15 | Facility | None | $33.88 | $37.15 | $37.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4.90 Median $37.15 Typical High $38.02 | Professional | None | $4.90 | $37.15 | $38.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $436.52 | Facility | None | $234.42 | $331.13 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $32.36 | Professional | None | $28.84 | $29.51 | $32.36 |
Select Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $20.42 | Facility | None | $19.50 | $19.50 | $20.42 |
Select Health Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $35.48 | Professional | None | $19.50 | $19.50 | $35.48 |
United Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $33.88 | Professional | None | $19.05 | $21.38 | $33.88 |
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 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 52 · Reduced service | $12.02 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $5.37 | Professional | 53 · Discontinued | $4.79 | $4.79 | $5.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $15.14 Median $29.51 Typical High $32.36 | Professional | 78 · Unplanned return to OR | $15.14 | $29.51 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 52 · Reduced service | $12.02 | $12.02 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $5.37 | Professional | 53 · Discontinued | $4.79 | $4.79 | $5.37 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 22 · Increased work | $23.99 | $23.99 | $23.99 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 54 · Surgery only | $15.14 | $15.14 | $15.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 63 · Small infant | $23.99 | $23.99 | $23.99 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 78 · Unplanned return to OR | $16.22 | $16.22 | $16.22 |
Where Idaho sits
The same service costs 2.3 times more in Minnesota 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· 10th of 51
$28.84
MN $39.81KY $17.38
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.