How much rates vary
Facilitymedian $363 · 10th to 90th $141 to $1,413Professionalmedian $170 · 10th to 90th $132 to $214
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 $112.20 Median $151.36 Typical High $169.82 | Professional | None | $112.20 | $151.36 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $1,778.28 | Facility | None | $331.13 | $537.03 | $1,778.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $245.47 | Professional | None | $154.88 | $177.83 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $173.78 | Professional | None | $125.89 | $154.88 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $169.82 Typical High $5,495.41 | Facility | None | $109.65 | $169.82 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $213.80 | Professional | None | $147.91 | $169.82 | $213.80 |
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 $199.53 | Facility | None | $138.04 | $147.91 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $234.42 | Professional | None | $147.91 | $173.78 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $213.80 | Professional | None | $154.88 | $173.78 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $933.25 | Facility | None | $109.65 | $112.20 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | None | $109.65 | $109.65 | $141.25 |
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 $109.65 Median $147.91 Typical High $194.98 | Professional | None | $109.65 | $147.91 | $194.98 |
7 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $165.96 | $213.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $23.99 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 63 · Small infant | $204.17 | $223.87 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $117.49 | $117.49 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $18.62 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $141.25 |
Where Idaho sits
The same service costs 16.3 times more in Oklahoma 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.
Physician feeFacility fee
OK $4,016DE $247
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.