How much rates vary
Facilitymedian $93 · 10th to 90th $62 to $166Professionalmedian $62 · 10th to 90th $58 to $95
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 Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $181.97 | Facility | None | $77.62 | $109.65 | $181.97 |
BCBS Idaho Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $114.82 | Professional | None | $60.26 | $60.26 | $114.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $42.66 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $39.81 | $42.66 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $69.18 Typical High $165.96 | Facility | None | $67.61 | $69.18 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $89.13 | Facility | None | $61.66 | $61.66 | $89.13 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
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 $57.54 Median $66.07 Typical High $93.33 | Facility | None | $57.54 | $66.07 | $93.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $109.65 | Professional | None | $57.54 | $66.07 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $87.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $190.55 | Facility | None | $117.49 | $134.90 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $114.82 | Professional | None | $64.57 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
9 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 $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 22 · Increased work | $125.89 | $125.89 | $125.89 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $81.28 | $81.28 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 63 · Small infant | $125.89 | $125.89 | $125.89 |
Where Idaho sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 31st of 51
$61.66
AK $91.20HI $56.23
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.