How much rates vary
Facilitymedian $479 · 10th to 90th $229 to $4,169Professionalmedian $347 · 10th to 90th $214 to $550
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 $199.53 Median $316.23 Typical High $537.03 | Professional | None | $199.53 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $398.11 | Professional | 54 · Surgery only | $151.36 | $239.88 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $79.43 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $371.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $234.42 Median $954.99 Typical High $4,265.80 | Facility | None | $234.42 | $954.99 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $549.54 | Professional | None | $257.04 | $389.05 | $549.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $489.78 | Professional | 54 · Surgery only | $229.09 | $269.15 | $489.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $54.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $331.13 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $199.53 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $229.09 Typical High $309.03 | Facility | None | $204.17 | $229.09 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $416.87 | Professional | None | $213.80 | $288.40 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $457.09 Typical High $5,495.41 | Facility | None | $154.88 | $457.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | None | $234.42 | $371.54 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $398.11 | Professional | 54 · Surgery only | $151.36 | $239.88 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $79.43 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $371.54 |
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 $512.86 | Facility | None | $275.42 | $275.42 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $645.65 | Professional | None | $275.42 | $346.74 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | 54 · Surgery only | $239.88 | $239.88 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $426.58 |
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 $309.03 Median $371.54 Typical High $616.60 | Professional | None | $309.03 | $371.54 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $1,479.11 | Facility | None | $245.47 | $251.19 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $323.59 | Professional | None | $154.88 | $239.88 | $323.59 |
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 $169.82 Median $275.42 Typical High $467.74 | Professional | None | $169.82 | $275.42 | $467.74 |
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 $100.00 Median $158.49 Typical High $269.15 | Professional | 52 · Reduced service | $100.00 | $158.49 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $107.15 | Professional | 53 · Discontinued | $39.81 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $53.70 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $309.03 Median $363.08 Typical High $676.08 | Professional | 63 · Small infant | $309.03 | $363.08 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $158.49 Typical High $269.15 | Professional | 52 · Reduced service | $100.00 | $158.49 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $107.15 | Professional | 53 · Discontinued | $39.81 | $63.10 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $53.70 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $56.23 |
Where Idaho sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$347
AK $661KY $151
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.