How much rates vary
Facilitymedian $295 · 10th to 90th $126 to $631Professionalmedian $166 · 10th to 90th $120 to $269
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 $162.18 Median $1,412.54 Typical High $7,079.46 | Facility | None | $162.18 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $213.80 | Professional | None | $91.20 | $131.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $97.72 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $93.33 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $91.20 | $93.33 | $147.91 |
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 $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $223.87 | Professional | 54 · Surgery only | $120.23 | $134.90 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $109.65 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $93.33 | $109.65 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $218.78 | Professional | None | $120.23 | $154.88 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $4,466.84 | Facility | None | $87.10 | $186.21 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $269.15 | Professional | None | $123.03 | $165.96 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $158.49 | Professional | 54 · Surgery only | $97.72 | $97.72 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $91.20 | $91.20 | $147.91 |
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 $120.23 Median $125.89 Typical High $229.09 | Facility | None | $120.23 | $125.89 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $269.15 | Professional | None | $125.89 | $162.18 | $269.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $181.97 |
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 $134.90 Median $173.78 Typical High $269.15 | Professional | None | $134.90 | $173.78 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $354.81 | Facility | None | $128.82 | $131.83 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
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 $93.33 Median $151.36 Typical High $234.42 | Professional | None | $93.33 | $151.36 | $234.42 |
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 $66.07 Median $66.07 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $66.07 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $21.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $30.20 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $162.18 Median $245.47 Typical High $363.08 | Professional | 63 · Small infant | $162.18 | $245.47 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $66.07 Typical High $107.15 | Professional | 52 · Reduced service | $66.07 | $66.07 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $26.30 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $31.62 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $21.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $23.99 |
Where Idaho sits
The same service costs 3.5 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· 13th of 51
$166
AK $355KY $100
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.