How much rates vary
Facilitymedian $95 · 10th to 90th $68 to $251Professionalmedian $100 · 10th to 90th $69 to $145
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 Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $117.49 | Professional | None | $70.79 | $89.13 | $117.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.38 Median $251.19 Typical High $251.19 | Facility | None | $17.38 | $251.19 | $251.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $144.54 | Professional | None | $117.49 | $131.83 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $134.90 | Professional | None | $91.20 | $114.82 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $151.36 | Facility | None | $66.07 | $95.50 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $169.82 | Professional | None | $67.61 | $89.13 | $169.82 |
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 $114.82 Median $125.89 Typical High $125.89 | Facility | None | $114.82 | $125.89 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $141.25 | Professional | None | $100.00 | $117.49 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Facility | None | $67.61 | $67.61 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $128.82 | Professional | None | $67.61 | $67.61 | $128.82 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $131.83 | Professional | None | $69.18 | $100.00 | $131.83 |
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 $33.11 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $8.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $97.72 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $83.18 | $97.72 | $104.71 |
Moda Health Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $61.66 Median $114.82 Typical High $257.04 | Professional | 24 · Unrelated visit after surgery | $61.66 | $114.82 | $257.04 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $117.49 Typical High $309.03 | Professional | 25 · Same-day visit | $61.66 | $117.49 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $35.48 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.08 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $74.13 Median $154.88 Typical High $213.80 | Professional | GC · Resident with teaching physician | $74.13 | $154.88 | $213.80 |
Where Idaho sits
The same service costs 2.4 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· 12th of 51
$100
AK $155AL $64.57
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.