How much rates vary
Facilitymedian $49 · 10th to 90th $39 to $1,778Professionalmedian $49 · 10th to 90th $20 to $74
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 $26.92 Median $64.57 Typical High $64.57 | Professional | None | $26.92 | $64.57 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $30.20 Median $45.71 Typical High $77.62 | Facility | None | $30.20 | $45.71 | $77.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $53.70 | Professional | None | $33.88 | $51.29 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $72.44 | Facility | None | $45.71 | $48.98 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $51.29 Typical High $64.57 | Professional | None | $26.92 | $51.29 | $64.57 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $40.74 | Professional | None | $30.20 | $34.67 | $40.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $60.26 Median $1,778.28 Typical High $2,884.03 | Facility | None | $60.26 | $1,778.28 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $3,388.44 | Professional | None | $51.29 | $60.26 | $3,388.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $48.98 Typical High $57.54 | Facility | None | $47.86 | $48.98 | $57.54 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $112.20 | Professional | None | $48.98 | $52.48 | $112.20 |
United Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $36.31 | Professional | None | $15.85 | $19.95 | $36.31 |
11 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 $13.49 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $13.49 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $5.37 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $20.42 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $4.07 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.69 | $6.46 | $6.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $35.48 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $31.62 | $35.48 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $13.49 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $5.37 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $20.42 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $4.07 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.69 | $6.46 | $6.46 |
Where Idaho sits
The same service costs 2.8 times more in Hawaii 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· 3rd of 51
$48.98
HI $51.29NY $18.62
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.