How much rates vary
Facilitymedian $363 · 10th to 90th $55 to $2,042Professionalmedian $71 · 10th to 90th $51 to $85
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 $42.66 Median $70.79 Typical High $70.79 | Professional | None | $42.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 54 · Surgery only | $47.86 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $10.72 |
BCBS Idaho Setting Facility Modifier None Typical Low $52.48 Median $851.14 Typical High $1,905.46 | Facility | None | $52.48 | $851.14 | $1,905.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $83.18 | Professional | None | $67.61 | $72.44 | $83.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $67.61 Typical High $75.86 | Professional | 54 · Surgery only | $60.26 | $67.61 | $75.86 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $6.76 | $7.59 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $72.44 | Professional | None | $57.54 | $64.57 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $5,495.41 | Facility | None | $54.95 | $100.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $87.10 | Professional | None | $64.57 | $70.79 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 54 · Surgery only | $47.86 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $10.72 |
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 $54.95 Median $64.57 Typical High $64.57 | Facility | None | $54.95 | $64.57 | $64.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | None | $64.57 | $75.86 | $75.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $87.10 | Professional | None | $67.61 | $67.61 | $87.10 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $151.36 | Facility | None | $36.31 | $37.15 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
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 $46.77 Median $61.66 Typical High $85.11 | Professional | None | $46.77 | $61.66 | $85.11 |
8 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 $31.62 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.59 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $7.08 | $7.08 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 63 · Small infant | $81.28 | $89.13 | $102.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $52.48 Typical High $58.88 | Professional | 78 · Unplanned return to OR | $46.77 | $52.48 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.59 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $7.08 | $7.08 |
Where Idaho sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 21st of 51
$70.79
OK $575NY $41.69
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.