How much rates vary
Facilitymedian $40 · 10th to 90th $32 to $66Professionalmedian $45 · 10th to 90th $31 to $69
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 $37.15 Median $44.67 Typical High $44.67 | Professional | None | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $4.47 | $4.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $93.33 | Facility | None | $64.57 | $77.62 | $93.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $74.13 | Professional | None | $50.12 | $61.66 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $44.67 Typical High $46.77 | Facility | None | $34.67 | $44.67 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $58.88 | Professional | None | $37.15 | $44.67 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $4.47 | $4.47 |
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 $35.48 Median $39.81 Typical High $57.54 | Facility | None | $35.48 | $39.81 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $67.61 | Professional | None | $35.48 | $39.81 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $52.48 | Professional | None | $42.66 | $50.12 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Facility | None | $32.36 | $32.36 | $33.11 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $63.10 | Professional | None | $30.90 | $38.90 | $63.10 |
United Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $60.26 | Professional | None | $36.31 | $45.71 | $60.26 |
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 $42.66 Median $48.98 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $42.66 | $48.98 | $51.29 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 22 · Increased work | $66.07 | $66.07 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 54 · Surgery only | $42.66 | $42.66 | $42.66 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 63 · Small infant | $66.07 | $66.07 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $45.71 | $45.71 | $45.71 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in New York. 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
$44.67
AK $89.13NY $30.20
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.