How much rates vary
Facilitymedian $1,230 · 10th to 90th $324 to $7,244Professionalmedian $537 · 10th to 90th $372 to $794
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 $346.74 Median $537.03 Typical High $758.58 | Professional | None | $346.74 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $263.03 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $81.28 Typical High $114.82 | Professional | 55 · Aftercare only | $52.48 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $537.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $346.74 Median $1,995.26 Typical High $8,317.64 | Facility | None | $346.74 | $1,995.26 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $812.83 | Professional | None | $436.52 | $588.84 | $812.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $741.31 | Professional | 54 · Surgery only | $398.11 | $478.63 | $741.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $43.65 | $66.07 | $83.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $363.08 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $309.03 | $363.08 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $323.59 Typical High $436.52 | Facility | None | $288.40 | $323.59 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $602.56 | Professional | None | $354.81 | $436.52 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $758.58 Typical High $5,495.41 | Facility | None | $275.42 | $758.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $776.25 | Professional | None | $407.38 | $630.96 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $263.03 | $398.11 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $81.28 Typical High $114.82 | Professional | 55 · Aftercare only | $52.48 | $81.28 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $537.03 |
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 $478.63 Median $478.63 Typical High $741.31 | Facility | None | $478.63 | $478.63 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $933.25 | Professional | None | $478.63 | $602.56 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | 54 · Surgery only | $407.38 | $407.38 | $575.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $891.25 | Professional | None | $524.81 | $630.96 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $4,677.35 | Facility | None | $354.81 | $363.08 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $478.63 | Professional | None | $269.15 | $354.81 | $478.63 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $741.31 | Professional | None | $302.00 | $457.09 | $741.31 |
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 $173.78 Median $269.15 Typical High $380.19 | Professional | 52 · Reduced service | $173.78 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $107.15 Typical High $151.36 | Professional | 53 · Discontinued | $69.18 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $34.67 | $53.70 | $75.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $524.81 Median $724.44 Typical High $977.24 | Professional | 63 · Small infant | $524.81 | $724.44 | $977.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $269.15 Typical High $380.19 | Professional | 52 · Reduced service | $173.78 | $269.15 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $107.15 Typical High $151.36 | Professional | 53 · Discontinued | $69.18 | $107.15 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $34.67 | $53.70 | $75.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $83.18 |
Where Idaho sits
The same service costs 5.2 times more in Alaska than in Texas. 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
$537
AK $1,148TX $219
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.