How much rates vary
Facilitymedian $1,380 · 10th to 90th $676 to $4,898Professionalmedian $1,288 · 10th to 90th $1,000 to $1,738
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 $891.25 Median $1,096.48 Typical High $1,380.38 | Professional | None | $891.25 | $1,096.48 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,137.96 | $5,495.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,380.38 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $1,479.11 |
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 $912.01 Median $1,148.15 Typical High $1,412.54 | Professional | None | $912.01 | $1,148.15 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $5,495.41 | Facility | None | $660.69 | $1,202.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,380.38 | $1,737.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,023.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $954.99 |
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 $1,047.13 Median $1,096.48 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,096.48 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,288.25 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,380.38 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $5,888.44 | Facility | None | $891.25 | $912.01 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Professional | None | $891.25 | $891.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,548.82 | Professional | None | $794.33 | $1,096.48 | $1,548.82 |
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 $549.54 Median $549.54 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $138.04 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $194.98 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,737.80 Typical High $2,454.71 | Professional | 63 · Small infant | $1,445.44 | $1,737.80 | $2,454.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $549.54 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $549.54 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $151.36 |
Where Idaho sits
The same service costs 3.7 times more in Alaska 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
AK $6,113DE $1,645
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.