How much rates vary
Facilitymedian $219 · 10th to 90th $145 to $1,047Professionalmedian $240 · 10th to 90th $182 to $398
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 $162.18 Median $199.53 Typical High $316.23 | Professional | None | $162.18 | $199.53 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $218.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $1,047.13 | Facility | None | $120.23 | $194.98 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $426.58 | Professional | None | $199.53 | $269.15 | $426.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $389.05 | Professional | 54 · Surgery only | $177.83 | $218.78 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $218.78 | Facility | None | $144.54 | $162.18 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $323.59 | Professional | None | $181.97 | $229.09 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $275.42 Typical High $5,495.41 | Facility | None | $134.90 | $275.42 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $398.11 | Professional | None | $181.97 | $251.19 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $147.91 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $218.78 |
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 $173.78 Median $186.21 Typical High $338.84 | Facility | None | $173.78 | $186.21 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $398.11 | Professional | None | $186.21 | $234.42 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $245.47 | Professional | 54 · Surgery only | $154.88 | $154.88 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $263.03 |
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 $199.53 Median $257.04 Typical High $398.11 | Professional | None | $199.53 | $257.04 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $371.54 | Facility | None | $186.21 | $190.55 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | None | $186.21 | $186.21 | $263.03 |
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 $144.54 Median $223.87 Typical High $338.84 | Professional | None | $144.54 | $223.87 | $338.84 |
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 $100.00 Median $100.00 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $31.62 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $44.67 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $44.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $288.40 Typical High $467.74 | Professional | 63 · Small infant | $239.88 | $288.40 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $100.00 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $39.81 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $31.62 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $35.48 |
Where Idaho sits
The same service costs 3.5 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· 12th of 51
$240
AK $525MD $151
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.