How much rates vary
Facilitymedian $380 · 10th to 90th $112 to $1,202Professionalmedian $427 · 10th to 90th $302 to $741
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $588.84 | Professional | None | $323.59 | $371.54 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $281.84 Typical High $446.68 | Professional | 54 · Surgery only | $239.88 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $223.87 | $263.03 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $501.19 Typical High $1,202.26 | Facility | None | $66.07 | $501.19 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $794.33 | Professional | None | $331.13 | $512.86 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $309.03 | $588.84 | $724.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $645.65 | Professional | None | $302.00 | $407.38 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $354.81 Typical High $4,466.84 | Facility | None | $181.97 | $354.81 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $741.31 | Professional | None | $323.59 | $426.58 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $446.68 | Professional | 54 · Surgery only | $239.88 | $239.88 | $446.68 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $416.87 |
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 $309.03 Median $331.13 Typical High $630.96 | Facility | None | $309.03 | $331.13 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $741.31 | Professional | None | $331.13 | $446.68 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $257.04 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $741.31 | Professional | None | $331.13 | $436.52 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $363.08 | Facility | None | $162.18 | $354.81 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
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 $251.19 Median $446.68 Typical High $724.44 | Professional | None | $251.19 | $446.68 | $724.44 |
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 $162.18 Median $186.21 Typical High $295.12 | Professional | 52 · Reduced service | $162.18 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $117.49 | Professional | 53 · Discontinued | $64.57 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $89.13 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $58.88 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $58.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $35.48 | $66.07 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $436.52 Median $512.86 Typical High $912.01 | Professional | 63 · Small infant | $436.52 | $512.86 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $295.12 | Professional | 52 · Reduced service | $162.18 | $162.18 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $117.49 | Professional | 53 · Discontinued | $64.57 | $64.57 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $89.13 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $58.88 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $66.07 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $66.07 |
Where Idaho sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 13th of 51
$427
AK $1,000TX $219
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.