How much rates vary
Facilitymedian $316 · 10th to 90th $141 to $631Professionalmedian $229 · 10th to 90th $170 to $355
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 $131.83 Median $186.21 Typical High $295.12 | Professional | None | $131.83 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $204.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $112.20 Median $316.23 Typical High $602.56 | Facility | None | $112.20 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $389.05 | Professional | None | $186.21 | $251.19 | $389.05 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $363.08 | Professional | 54 · Surgery only | $169.82 | $204.17 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $302.00 | Professional | None | $169.82 | $213.80 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $5,495.41 | Facility | None | $128.82 | $257.04 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $371.54 | Professional | None | $169.82 | $234.42 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $138.04 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $204.17 |
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 $165.96 Median $173.78 Typical High $316.23 | Facility | None | $165.96 | $173.78 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $371.54 | Professional | None | $173.78 | $218.78 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $147.91 | $147.91 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $245.47 |
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 $186.21 Median $239.88 Typical High $371.54 | Professional | None | $186.21 | $239.88 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $354.81 | Facility | None | $173.78 | $177.83 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $245.47 | Professional | None | $173.78 | $173.78 | $245.47 |
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 $134.90 Median $208.93 Typical High $316.23 | Professional | None | $134.90 | $208.93 | $316.23 |
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 $93.33 Median $93.33 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $29.51 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $38.90 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $38.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $398.11 Typical High $489.78 | Professional | 63 · Small infant | $223.87 | $398.11 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $93.33 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $37.15 | $37.15 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $33.11 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 11th of 51
$234
AK $490MD $148
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.