How much rates vary
Facilitymedian $132 · 10th to 90th $60 to $417Professionalmedian $123 · 10th to 90th $102 to $170
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 $97.72 Median $114.82 Typical High $114.82 | Professional | None | $97.72 | $114.82 | $114.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $51.29 Median $131.83 Typical High $416.87 | Facility | None | $51.29 | $131.83 | $416.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $173.78 | Professional | None | $104.71 | $144.54 | $173.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $114.82 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $87.10 | $114.82 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | None | $107.15 | $117.49 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $398.11 | Facility | None | $102.33 | $114.82 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $147.91 | Professional | None | $107.15 | $114.82 | $147.91 |
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 $131.83 Median $144.54 Typical High $144.54 | Facility | None | $131.83 | $144.54 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $147.91 | Professional | None | $125.89 | $144.54 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $93.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $147.91 | Professional | None | $104.71 | $123.03 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | None | $75.86 | $75.86 | $128.82 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $169.82 | Professional | None | $87.10 | $131.83 | $169.82 |
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 $51.29 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $51.29 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $11.48 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 22 · Increased work | $138.04 | $138.04 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $87.10 | $87.10 | $87.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 63 · Small infant | $138.04 | $138.04 | $138.04 |
Where Idaho sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 15th of 51
$123
AK $234UT $81.28
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.