How much rates vary
Facilitymedian $282 · 10th to 90th $132 to $661Professionalmedian $339 · 10th to 90th $195 to $741
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $724.44 | Professional | None | $181.97 | $288.40 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $537.03 | Professional | 54 · Surgery only | $138.04 | $213.80 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $107.15 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $501.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $524.81 | Facility | None | $131.83 | $234.42 | $524.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $512.86 Typical High $794.33 | Professional | None | $257.04 | $512.86 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $707.95 | Professional | 54 · Surgery only | $234.42 | $281.84 | $707.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $79.43 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $79.43 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $218.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $181.97 | $218.78 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $186.21 | Facility | None | $120.23 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $524.81 | Professional | None | $186.21 | $263.03 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $407.38 Typical High $1,023.29 | Facility | None | $181.97 | $407.38 | $1,023.29 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $724.44 | Professional | None | $239.88 | $338.84 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $213.80 Typical High $537.03 | Professional | 54 · Surgery only | $141.25 | $213.80 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $107.15 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $501.19 |
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 $281.84 Median $281.84 Typical High $724.44 | Facility | None | $281.84 | $281.84 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $912.01 | Professional | None | $281.84 | $354.81 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $524.81 | Professional | 54 · Surgery only | $218.78 | $218.78 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $831.76 | Professional | None | $288.40 | $338.84 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $389.05 | Facility | None | $288.40 | $346.74 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $416.87 | Professional | None | $123.03 | $218.78 | $416.87 |
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 $151.36 Median $281.84 Typical High $524.81 | Professional | None | $151.36 | $281.84 | $524.81 |
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 $91.20 Median $144.54 Typical High $354.81 | Professional | 52 · Reduced service | $91.20 | $144.54 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $144.54 | Professional | 53 · Discontinued | $36.31 | $57.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $72.44 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $72.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $309.03 Median $380.19 Typical High $891.25 | Professional | 63 · Small infant | $309.03 | $380.19 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $144.54 Typical High $354.81 | Professional | 52 · Reduced service | $91.20 | $144.54 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $144.54 | Professional | 53 · Discontinued | $36.31 | $57.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $72.44 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $75.86 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $75.86 |
Where Idaho sits
The same service costs 3.6 times more in Wisconsin 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· 13th of 51
$331
WI $603KY $166
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.