How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,380 to $9,120Professionalmedian $1,549 · 10th to 90th $1,259 to $1,905
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,412.54 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $9,332.54 | Facility | None | $1,513.56 | $2,754.23 | $9,332.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,698.24 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,235.94 | Facility | None | $2,137.96 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $5,495.41 | Facility | None | $891.25 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
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 $1,288.25 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,288.25 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,698.24 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,760.83 Median $9,120.11 Typical High $11,748.98 | Facility | None | $6,760.83 | $9,120.11 | $11,748.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,548.82 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $3,548.13 | Facility | None | $851.14 | $851.14 | $3,548.13 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,288.25 | Professional | None | $851.14 | $851.14 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,318.26 | $1,819.70 |
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 $707.95 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $707.95 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $151.36 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,071.52 Typical High $1,230.27 | Professional | 62 · Two surgeons | $954.99 | $1,071.52 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $2,041.74 Typical High $2,398.83 | Professional | 63 · Small infant | $1,819.70 | $2,041.74 | $2,398.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $707.95 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $281.84 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $151.36 |
Where Idaho sits
The same service costs 8.3 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· 16th of 51
$1,585
AK $4,074TX $490
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.