How much rates vary
Facilitymedian $145 · 10th to 90th $91 to $214Professionalmedian $120 · 10th to 90th $83 to $200
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 $89.13 Median $89.13 Typical High $109.65 | Professional | None | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $44.67 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $234.42 | Facility | None | $144.54 | $151.36 | $234.42 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $208.93 | Professional | None | $144.54 | $177.83 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $109.65 | Facility | None | $89.13 | $89.13 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $169.82 | Professional | None | $89.13 | $89.13 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $44.67 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $17.78 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.96 |
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 $102.33 Median $114.82 Typical High $165.96 | Facility | None | $102.33 | $114.82 | $165.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $194.98 | Professional | None | $102.33 | $114.82 | $194.98 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $154.88 Typical High $234.42 | Facility | None | $144.54 | $154.88 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | None | $123.03 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $177.83 | Professional | None | $91.20 | $114.82 | $177.83 |
United Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $151.36 | Professional | None | $91.20 | $109.65 | $151.36 |
5 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 $120.23 Median $138.04 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $120.23 | $138.04 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 22 · Increased work | $186.21 | $186.21 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 63 · Small infant | $186.21 | $186.21 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $128.82 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 11th of 51
$120
AK $229KY $69.18
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.