How much rates vary
Facilitymedian $912 · 10th to 90th $347 to $4,169Professionalmedian $398 · 10th to 90th $302 to $550
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 $229.09 Median $346.74 Typical High $436.52 | Professional | None | $229.09 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $302.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $4,265.80 | Facility | None | $616.60 | $1,230.27 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $602.56 | Professional | None | $346.74 | $436.52 | $602.56 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $323.59 | $398.11 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $295.12 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $251.19 | $295.12 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $446.68 | Professional | None | $281.84 | $354.81 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $5,495.41 | Facility | None | $245.47 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $549.54 | Professional | None | $331.13 | $436.52 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $257.04 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $478.63 | Facility | None | $316.23 | $331.13 | $478.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $562.34 | Professional | None | $331.13 | $389.05 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $269.15 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $549.54 | Professional | None | $346.74 | $436.52 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $1,548.82 | Facility | None | $269.15 | $275.42 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $478.63 | Professional | None | $245.47 | $338.84 | $478.63 |
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 $218.78 | Professional | 52 · Reduced service | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $43.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 63 · Small infant | $436.52 | $478.63 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $169.82 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $69.18 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $47.86 |
Where Idaho sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 9th of 51
$427
AK $912KY $234
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.