How much rates vary
Facilitymedian $537 · 10th to 90th $102 to $3,981Professionalmedian $182 · 10th to 90th $123 to $257
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 $112.20 Median $181.97 Typical High $251.19 | Professional | None | $112.20 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $173.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $107.15 Median $616.60 Typical High $3,981.07 | Facility | None | $107.15 | $616.60 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $269.15 | Professional | None | $151.36 | $199.53 | $269.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $158.49 | $245.47 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $28.18 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $28.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $104.71 | $158.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $138.04 | Facility | None | $89.13 | $102.33 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $186.21 | Professional | None | $112.20 | $138.04 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $251.19 Typical High $5,495.41 | Facility | None | $112.20 | $251.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $257.04 | Professional | None | $138.04 | $213.80 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $134.90 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $173.78 |
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 $162.18 Median $162.18 Typical High $251.19 | Facility | None | $162.18 | $162.18 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $316.23 | Professional | None | $162.18 | $204.17 | $316.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $141.25 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $295.12 | Professional | None | $177.83 | $213.80 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $1,258.93 | Facility | None | $120.23 | $123.03 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $158.49 | Professional | None | $91.20 | $120.23 | $158.49 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $218.78 | Professional | None | $95.50 | $138.04 | $218.78 |
8 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 $56.23 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $56.23 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $36.31 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $18.20 | $25.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $218.78 Typical High $309.03 | Professional | 63 · Small infant | $181.97 | $218.78 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $56.23 | $91.20 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $36.31 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $36.31 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $18.20 | $25.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $27.54 |
Where Idaho sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$182
AK $363FL $91.20
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.