How much rates vary
Facilitymedian $138 · 10th to 90th $112 to $229Professionalmedian $151 · 10th to 90th $110 to $240
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 $125.89 Median $151.36 Typical High $151.36 | Professional | None | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $15.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $316.23 | Facility | None | $223.87 | $269.15 | $316.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $257.04 | Professional | None | $173.78 | $213.80 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $151.36 Typical High $158.49 | Facility | None | $120.23 | $151.36 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $204.17 | Professional | None | $125.89 | $151.36 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $15.14 |
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 $123.03 Median $138.04 Typical High $199.53 | Facility | None | $123.03 | $138.04 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $234.42 | Professional | None | $123.03 | $138.04 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $181.97 | Professional | None | $147.91 | $173.78 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $117.49 | Facility | None | $112.20 | $112.20 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $218.78 | Professional | None | $109.65 | $134.90 | $218.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $208.93 | Professional | None | $125.89 | $154.88 | $208.93 |
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 $144.54 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $144.54 | $169.82 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 22 · Increased work | $229.09 | $229.09 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $144.54 | $144.54 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 63 · Small infant | $229.09 | $229.09 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $154.88 |
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· 13th of 51
$151
AK $302NY $102
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.