How much rates vary
Facilitymedian $204 · 10th to 90th $129 to $603Professionalmedian $186 · 10th to 90th $132 to $347
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 $169.82 Median $309.03 Typical High $5,495.41 | Facility | None | $169.82 | $309.03 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $263.03 | Professional | None | $144.54 | $165.96 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $194.98 | Professional | 54 · Surgery only | $107.15 | $125.89 | $194.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $524.81 | Facility | None | $100.00 | $208.93 | $524.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $426.58 | Professional | None | $144.54 | $229.09 | $426.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $346.74 | Professional | 54 · Surgery only | $141.25 | $173.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $186.21 | Facility | None | $120.23 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $269.15 | Professional | None | $131.83 | $190.55 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $1,819.70 | Facility | None | $144.54 | $263.03 | $1,819.70 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $346.74 | Professional | None | $144.54 | $181.97 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $194.98 | Professional | 54 · Surgery only | $107.15 | $107.15 | $194.98 |
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 $138.04 Median $147.91 Typical High $346.74 | Facility | None | $138.04 | $147.91 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $407.38 | Professional | None | $147.91 | $239.88 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $204.17 | Professional | 54 · Surgery only | $109.65 | $109.65 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $331.13 | Professional | None | $144.54 | $190.55 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Facility | None | $190.55 | $190.55 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $288.40 | Professional | None | $104.71 | $181.97 | $288.40 |
13 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 $72.44 Median $83.18 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $26.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $45.71 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $186.21 Median $213.80 Typical High $524.81 | Professional | 63 · Small infant | $186.21 | $213.80 | $524.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $72.44 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $28.84 | $52.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $26.30 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $28.84 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $218.78 |
Where Idaho sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $3,027MD $261
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.