How much rates vary
Facilitymedian $1,698 · 10th to 90th $389 to $5,495Professionalmedian $339 · 10th to 90th $229 to $575
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $891.25 | Professional | None | $338.84 | $338.84 | $891.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $7,585.78 | Facility | None | $588.84 | $707.95 | $7,585.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $575.44 | Professional | None | $204.17 | $239.88 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $5,495.41 | Facility | None | $239.88 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $676.08 | Professional | None | $338.84 | $338.84 | $676.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $676.08 Typical High $933.25 | Facility | None | $588.84 | $676.08 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | None | $575.44 | $575.44 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Facility | None | $239.88 | $239.88 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $309.03 Median $389.05 Typical High $575.44 | Professional | None | $309.03 | $389.05 | $575.44 |
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 $169.82 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $38.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $169.82 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $257.04 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $38.90 |
Where Idaho sits
The same service costs 7.8 times more in Texas than in Delaware. 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· 47th of 51
$398
TX $2,399DE $309
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.