How much rates vary
Facilitymedian $63 · 10th to 90th $50 to $102Professionalmedian $69 · 10th to 90th $49 to $107
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 $56.23 Median $69.18 Typical High $69.18 | Professional | None | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $6.92 |
BCBS Idaho Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $144.54 | Facility | None | $100.00 | $120.23 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $114.82 | Professional | None | $79.43 | $97.72 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $69.18 Typical High $72.44 | Facility | None | $53.70 | $69.18 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | None | $56.23 | $69.18 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $6.92 |
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 $54.95 Median $63.10 Typical High $89.13 | Facility | None | $54.95 | $63.10 | $89.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $104.71 | Professional | None | $54.95 | $63.10 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $81.28 | Professional | None | $66.07 | $79.43 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Facility | None | $50.12 | $50.12 | $52.48 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $97.72 | Professional | None | $48.98 | $61.66 | $97.72 |
United Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | None | $56.23 | $69.18 | $93.33 |
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 $64.57 Median $75.86 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $64.57 | $75.86 | $79.43 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 22 · Increased work | $102.33 | $102.33 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $64.57 | $64.57 | $64.57 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 63 · Small infant | $102.33 | $102.33 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $69.18 | $69.18 | $69.18 |
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· 10th of 51
$69.18
AK $138NY $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.