How much rates vary
Facilitymedian $316 · 10th to 90th $148 to $708Professionalmedian $589 · 10th to 90th $363 to $708
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 $707.95 Median $741.31 Typical High $5,495.41 | Facility | None | $707.95 | $741.31 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $676.08 | Professional | None | $309.03 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $57.54 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $218.78 Typical High $707.95 | Facility | None | $109.65 | $218.78 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | None | $537.03 | $630.96 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $562.34 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $70.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $467.74 | Professional | None | $331.13 | $416.87 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $588.84 Typical High $891.25 | Facility | None | $263.03 | $588.84 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $707.95 | Professional | None | $380.19 | $588.84 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $288.40 | $436.52 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $57.54 | $89.13 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $436.52 |
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 $537.03 Median $575.44 Typical High $660.69 | Facility | None | $537.03 | $575.44 | $660.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $831.76 | Professional | None | $575.44 | $660.69 | $831.76 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $457.09 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Professional | None | $537.03 | $630.96 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $338.84 | Facility | None | $281.84 | $316.23 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $457.09 | Professional | None | $151.36 | $316.23 | $457.09 |
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 $295.12 Median $407.38 Typical High $602.56 | Professional | None | $295.12 | $407.38 | $602.56 |
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 $190.55 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $190.55 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $75.86 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $61.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $758.58 Typical High $851.14 | Professional | 63 · Small infant | $645.65 | $758.58 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $190.55 | $295.12 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $75.86 | $117.49 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $61.66 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $69.18 |
Where Idaho sits
The same service costs 5.6 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· 8th of 51
$589
AK $1,230TX $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.