How much rates vary
Facilitymedian $309 · 10th to 90th $95 to $631Professionalmedian $126 · 10th to 90th $95 to $191
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 $81.28 Median $107.15 Typical High $151.36 | Professional | None | $81.28 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | 54 · Surgery only | $81.28 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $316.23 Typical High $602.56 | Facility | None | $102.33 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $204.17 | Professional | None | $109.65 | $131.83 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $109.65 Typical High $190.55 | Professional | 54 · Surgery only | $97.72 | $109.65 | $190.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $91.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $77.62 | $91.20 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $154.88 | Professional | None | $87.10 | $109.65 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $131.83 Typical High $5,495.41 | Facility | None | $69.18 | $131.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $190.55 | Professional | None | $97.72 | $134.90 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | 54 · Surgery only | $81.28 | $81.28 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $107.15 |
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 $95.50 Median $100.00 Typical High $162.18 | Facility | None | $95.50 | $100.00 | $162.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $190.55 | Professional | None | $100.00 | $120.23 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $120.23 | Professional | 54 · Surgery only | $85.11 | $85.11 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $91.20 | $91.20 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $190.55 | Professional | None | $109.65 | $134.90 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $354.81 | Facility | None | $91.20 | $91.20 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
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 $75.86 Median $104.71 Typical High $162.18 | Professional | None | $75.86 | $104.71 | $162.18 |
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 $53.70 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $15.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $10.72 | $15.14 | $21.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $128.82 Median $199.53 Typical High $234.42 | Professional | 63 · Small infant | $128.82 | $199.53 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $53.70 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $21.38 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $15.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $16.98 |
Where Idaho sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 10th of 51
$135
AK $288KY $75.86
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.