How much rates vary
Facilitymedian $316 · 10th to 90th $204 to $437Professionalmedian $295 · 10th to 90th $204 to $380
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 $263.03 Median $263.03 Typical High $302.00 | Facility | None | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $309.03 | Professional | None | $194.98 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $100.00 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $30.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $501.19 | Facility | None | $263.03 | $338.84 | $501.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $407.38 | Professional | None | $302.00 | $354.81 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $346.74 | Professional | None | $213.80 | $275.42 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $323.59 | Facility | None | $213.80 | $263.03 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $346.74 | Professional | None | $204.17 | $263.03 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $100.00 | $131.83 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $39.81 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $30.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Facility | None | $323.59 | $323.59 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $380.19 | Professional | None | $323.59 | $338.84 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $39.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $501.19 | Facility | None | $316.23 | $331.13 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $758.58 | Professional | None | $199.53 | $281.84 | $758.58 |
United Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $346.74 | Professional | None | $199.53 | $251.19 | $346.74 |
6 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 50 · Both sides | $512.86 | $512.86 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $239.88 | $239.88 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 62 · Two surgeons | $213.80 | $213.80 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 66 · Surgical team Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 66 · Surgical team | $154.88 | $154.88 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $295.12 |
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· 4th of 51
$295
AK $380AL $158
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.