How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,072 to $5,888Professionalmedian $219 · 10th to 90th $182 to $372
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 Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $316.23 | Professional | None | $181.97 | $181.97 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $6,309.57 | Facility | None | $2,089.30 | $3,162.28 | $6,309.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | None | $186.21 | $218.78 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $5,495.41 | Facility | None | $181.97 | $218.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | None | $181.97 | $181.97 | $223.87 |
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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $69.18 Median $3,162.28 Typical High $3,162.28 | Professional | None | $69.18 | $3,162.28 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $6,309.57 | Facility | None | $3,388.44 | $5,011.87 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | None | $331.13 | $331.13 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Facility | None | $229.09 | $229.09 | $234.42 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | None | $144.54 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $436.52 | Professional | None | $223.87 | $295.12 | $436.52 |
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 $89.13 Median $89.13 Typical High $112.20 | Professional | 52 · Reduced service | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $22.39 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $134.90 | $134.90 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
Where Idaho sits
The same service costs 19.5 times more in Texas 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· 34th of 51
$331
TX $1,778NY $91.20
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.