How much rates vary
Facilitymedian $417 · 10th to 90th $195 to $4,169Professionalmedian $302 · 10th to 90th $204 to $457
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $446.68 | Professional | None | $186.21 | $302.00 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $331.13 | Professional | 54 · Surgery only | $141.25 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $309.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $426.58 Typical High $4,265.80 | Facility | None | $199.53 | $426.58 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $478.63 | Professional | None | $257.04 | $338.84 | $478.63 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $436.52 | Professional | 54 · Surgery only | $229.09 | $275.42 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $50.12 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $50.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $199.53 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $194.98 Typical High $269.15 | Facility | None | $173.78 | $194.98 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $338.84 | Professional | None | $194.98 | $239.88 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $446.68 Typical High $4,466.84 | Facility | None | $181.97 | $446.68 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $457.09 | Professional | None | $234.42 | $354.81 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $331.13 | Professional | 54 · Surgery only | $141.25 | $223.87 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $309.03 |
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 $275.42 Median $275.42 Typical High $446.68 | Facility | None | $275.42 | $275.42 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $562.34 | Professional | None | $275.42 | $346.74 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | 54 · Surgery only | $229.09 | $229.09 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $524.81 | Professional | None | $295.12 | $354.81 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $851.14 | Facility | None | $213.80 | $218.78 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $275.42 | Professional | None | $147.91 | $213.80 | $275.42 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $407.38 | Professional | None | $162.18 | $239.88 | $407.38 |
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 $95.50 Median $151.36 Typical High $223.87 | Professional | 52 · Reduced service | $95.50 | $151.36 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $60.26 Typical High $89.13 | Professional | 53 · Discontinued | $38.02 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $30.20 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.05 | $30.20 | $44.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $338.84 Median $478.63 Typical High $575.44 | Professional | 63 · Small infant | $338.84 | $478.63 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $151.36 Typical High $223.87 | Professional | 52 · Reduced service | $95.50 | $151.36 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $60.26 Typical High $89.13 | Professional | 53 · Discontinued | $38.02 | $60.26 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $30.20 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.05 | $30.20 | $44.67 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $47.86 |
Where Idaho sits
The same service costs 3.5 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
$302
AK $603FL $174
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.