How much rates vary
Facilitymedian $245 · 10th to 90th $117 to $1,862Professionalmedian $155 · 10th to 90th $102 to $309
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 $83.18 Median $138.04 Typical High $257.04 | Professional | None | $83.18 | $138.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $89.13 Typical High $190.55 | Professional | 54 · Surgery only | $79.43 | $89.13 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $38.02 | Professional | 55 · Aftercare only | $15.85 | $17.78 | $38.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $758.58 | Facility | None | $154.88 | $234.42 | $758.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $338.84 | Professional | None | $114.82 | $229.09 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $125.89 Typical High $316.23 | Professional | 54 · Surgery only | $104.71 | $125.89 | $316.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.45 Typical High $33.88 | Professional | 55 · Aftercare only | $11.75 | $14.45 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $269.15 | Professional | None | $107.15 | $177.83 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | None | $371.54 | $371.54 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $229.09 Typical High $5,495.41 | Facility | None | $97.72 | $229.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $316.23 | Professional | None | $104.71 | $154.88 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $190.55 | Professional | 54 · Surgery only | $89.13 | $89.13 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $38.02 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $38.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $91.20 | Professional | None | $33.11 | $33.11 | $91.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $288.40 | Facility | None | $117.49 | $117.49 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $309.03 | Professional | None | $117.49 | $186.21 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $316.23 | Professional | None | $114.82 | $190.55 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $416.87 | Facility | None | $147.91 | $151.36 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $229.09 | Professional | None | $117.49 | $147.91 | $229.09 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $288.40 | Professional | None | $83.18 | $165.96 | $288.40 |
10 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 $52.48 Median $58.88 Typical High $128.82 | Professional | 52 · Reduced service | $52.48 | $58.88 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.44 Typical High $51.29 | Professional | 53 · Discontinued | $20.89 | $23.44 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.75 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.47 | $11.75 | $25.70 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $229.09 Median $354.81 Typical High $1,122.02 | Facility | 50 · Both sides | $229.09 | $354.81 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $213.80 Typical High $501.19 | Professional | 50 · Both sides | $181.97 | $213.80 | $501.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $141.25 Median $169.82 Typical High $416.87 | Professional | 63 · Small infant | $141.25 | $169.82 | $416.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $100.00 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $85.11 | $100.00 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $128.82 | Professional | 52 · Reduced service | $58.88 | $58.88 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $51.29 | Professional | 53 · Discontinued | $23.44 | $23.44 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $25.70 |
Where Idaho sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 21st of 51
$162
WI $309UT $120
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.