How much rates vary
Facilitymedian $162 · 10th to 90th $35 to $776Professionalmedian $78 · 10th to 90th $52 to $110
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 $60.26 Median $93.33 Typical High $5,495.41 | Facility | None | $60.26 | $93.33 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $109.65 | Professional | None | $47.86 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $58.88 Typical High $83.18 | Professional | 54 · Surgery only | $35.48 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $16.60 | Professional | 55 · Aftercare only | $7.08 | $11.75 | $16.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $38.02 Median $316.23 Typical High $812.83 | Facility | None | $38.02 | $316.23 | $812.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $109.65 | Professional | None | $64.57 | $81.28 | $109.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $97.72 | Professional | 54 · Surgery only | $58.88 | $74.13 | $97.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.59 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $7.59 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $34.67 Typical High $46.77 | Facility | None | $30.90 | $34.67 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $85.11 | Professional | None | $51.29 | $63.10 | $85.11 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $131.83 Typical High $741.31 | Facility | None | $47.86 | $131.83 | $741.31 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $128.82 | Professional | None | $54.95 | $85.11 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $58.88 Typical High $83.18 | Professional | 54 · Surgery only | $35.48 | $58.88 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $16.60 | Professional | 55 · Aftercare only | $7.08 | $11.75 | $16.60 |
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 $70.79 Median $70.79 Typical High $102.33 | Facility | None | $70.79 | $70.79 | $102.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $128.82 | Professional | None | $70.79 | $89.13 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | 54 · Surgery only | $57.54 | $57.54 | $81.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $977.24 | Facility | None | $501.19 | $724.44 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $128.82 | Professional | None | $74.13 | $89.13 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $48.98 Typical High $457.09 | Facility | None | $47.86 | $48.98 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $66.07 | Professional | None | $31.62 | $47.86 | $66.07 |
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 $42.66 Median $61.66 Typical High $107.15 | Professional | None | $42.66 | $61.66 | $107.15 |
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 $23.99 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $23.99 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.49 Typical High $21.88 | Professional | 53 · Discontinued | $9.55 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.79 | $7.76 | $10.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | 63 · Small infant | $77.62 | $95.50 | $131.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $53.70 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $45.71 | $53.70 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $23.99 | $38.90 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.49 Typical High $21.88 | Professional | 53 · Discontinued | $9.55 | $15.49 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.79 | $7.76 | $10.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.75 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $61.66 | $61.66 | $87.10 |
Where Idaho sits
The same service costs 4.2 times more in Alaska than in New York. 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
$77.62
AK $186NY $44.67
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.