How much rates vary
Facilitymedian $1,445 · 10th to 90th $1,000 to $4,786Professionalmedian $1,175 · 10th to 90th $912 to $1,585
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 $870.96 Median $1,023.29 Typical High $1,258.93 | Professional | None | $870.96 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $891.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $4,897.79 | Facility | None | $1,380.38 | $2,187.76 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,288.25 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,659.59 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,318.26 | Professional | None | $831.76 | $1,047.13 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $5,495.41 | Facility | None | $691.83 | $1,096.48 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,258.93 | $1,584.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $758.58 | $954.99 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $891.25 |
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 $954.99 Median $1,000.00 Typical High $1,445.44 | Facility | None | $954.99 | $1,000.00 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,174.90 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,786.30 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,288.25 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $3,801.89 | Facility | None | $812.83 | $831.76 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,412.54 | Professional | None | $741.31 | $1,000.00 | $1,412.54 |
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 $501.19 Median $501.19 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $125.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $173.78 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $173.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,288.25 Median $1,698.24 Typical High $2,187.76 | Professional | 63 · Small infant | $1,288.25 | $1,698.24 | $2,187.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $501.19 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $125.89 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $141.25 |
Where Idaho sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.