How much rates vary
Facilitymedian $2,239 · 10th to 90th $871 to $8,710Professionalmedian $2,344 · 10th to 90th $1,698 to $3,162
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 Professional Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,454.71 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $371.54 Typical High $446.68 | Professional | 55 · Aftercare only | $223.87 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,698.24 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,698.24 | $2,089.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $3,801.89 Typical High $9,772.37 | Facility | None | $912.01 | $3,801.89 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,235.94 | Professional | None | $1,949.84 | $2,630.27 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $323.59 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $323.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,819.70 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,819.70 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $870.96 Typical High $1,202.26 | Facility | None | $776.25 | $870.96 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,905.46 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,412.54 | $2,454.71 | $3,467.37 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,511.89 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $371.54 Typical High $446.68 | Professional | 55 · Aftercare only | $223.87 | $371.54 | $446.68 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,698.24 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,698.24 | $2,089.30 |
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 $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,630.27 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $10,471.29 | Facility | None | $5,248.07 | $8,128.31 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,344.23 | $2,884.03 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $10,471.29 | Facility | None | $1,412.54 | $1,445.44 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Professional | None | $812.83 | $1,412.54 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,089.30 | $3,090.30 |
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 $741.31 Median $1,230.27 Typical High $1,513.56 | Professional | 52 · Reduced service | $741.31 | $1,230.27 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $489.78 Typical High $602.56 | Professional | 53 · Discontinued | $295.12 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $245.47 Typical High $302.00 | Professional | 56 · Pre-op care only | $147.91 | $245.47 | $302.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,344.23 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,698.24 | $2,344.23 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,238.72 Median $2,754.23 Typical High $3,715.35 | Professional | 63 · Small infant | $2,238.72 | $2,754.23 | $3,715.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $1,230.27 Typical High $1,513.56 | Professional | 52 · Reduced service | $741.31 | $1,230.27 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $489.78 Typical High $602.56 | Professional | 53 · Discontinued | $295.12 | $489.78 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $245.47 Typical High $302.00 | Professional | 56 · Pre-op care only | $147.91 | $245.47 | $302.00 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $323.59 |
Where Idaho sits
The same service costs 5.1 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· 10th of 51
$2,344
AK $4,677TX $912
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.