How much rates vary
Facilitymedian $110 · 10th to 90th $32 to $417Professionalmedian $50 · 10th to 90th $29 to $89
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $57.54 | Professional | None | $26.92 | $42.66 | $57.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $173.78 | Facility | None | $79.43 | $112.20 | $173.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $107.15 | Professional | None | $48.98 | $58.88 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $26.30 Median $42.66 Typical High $4,466.84 | Facility | None | $26.30 | $42.66 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $89.13 | Professional | None | $28.84 | $44.67 | $89.13 |
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 $28.18 Median $45.71 Typical High $79.43 | Facility | None | $28.18 | $45.71 | $79.43 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.18 Median $51.29 Typical High $83.18 | Professional | None | $28.18 | $51.29 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $81.28 | Professional | None | $48.98 | $56.23 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $46.77 Median $47.86 Typical High $123.03 | Facility | None | $46.77 | $47.86 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $66.07 | Professional | None | $33.88 | $46.77 | $66.07 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $89.13 | Professional | None | $36.31 | $54.95 | $89.13 |
11 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 $13.18 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $13.18 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $5.25 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $31.62 Typical High $33.88 | Professional | 54 · Surgery only | $19.95 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.31 Typical High $6.76 | Professional | 55 · Aftercare only | $3.98 | $6.31 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.63 | $4.27 | $4.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $63.10 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $38.90 | $63.10 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $13.18 | $21.38 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $5.25 | $8.51 | $8.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $31.62 Typical High $33.88 | Professional | 54 · Surgery only | $19.95 | $31.62 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.31 Typical High $6.76 | Professional | 55 · Aftercare only | $3.98 | $6.31 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.63 | $4.27 | $4.47 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in California. 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· 34th of 51
$51.29
AK $129CA $46.77
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.