How much rates vary
Facilitymedian $209 · 10th to 90th $145 to $282Professionalmedian $204 · 10th to 90th $148 to $302
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 $177.83 Median $213.80 Typical High $281.84 | Facility | None | $177.83 | $213.80 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $239.88 | Professional | None | $134.90 | $190.55 | $239.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $15.14 Median $295.12 Typical High $331.13 | Facility | None | $15.14 | $295.12 | $331.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $346.74 | Professional | None | $194.98 | $251.19 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $263.03 | Professional | None | $151.36 | $208.93 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $204.17 Typical High $251.19 | Facility | None | $117.49 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $295.12 | Professional | None | $144.54 | $204.17 | $295.12 |
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 $208.93 Median $208.93 Typical High $316.23 | Facility | None | $208.93 | $208.93 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | None | $208.93 | $251.19 | $316.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $295.12 | Professional | None | $181.97 | $234.42 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $331.13 | Facility | None | $165.96 | $169.82 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $467.74 | Professional | None | $134.90 | $208.93 | $467.74 |
United Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $257.04 | Professional | None | $138.04 | $177.83 | $257.04 |
13 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 $74.13 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $20.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $165.96 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $151.36 | $165.96 | $251.19 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $204.17 Typical High $588.84 | Professional | 25 · Same-day visit | $107.15 | $204.17 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $20.89 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $112.20 Median $181.97 Typical High $794.33 | Professional | 57 · Decision for surgery | $112.20 | $181.97 | $794.33 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $138.04 Median $275.42 Typical High $316.23 | Professional | GC · Resident with teaching physician | $138.04 | $275.42 | $316.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $173.78 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $31.62 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $234.42 |
Where Idaho sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$209
AK $263AL $115
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.