How much rates vary
Facilitymedian $603 · 10th to 90th $135 to $1,413Professionalmedian $229 · 10th to 90th $105 to $661
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 $117.49 Median $1,412.54 Typical High $7,079.46 | Facility | None | $117.49 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $660.69 | Professional | None | $81.28 | $208.93 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $501.19 | Professional | 54 · Surgery only | $87.10 | $128.82 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $100.00 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $870.96 | Facility | None | $457.09 | $660.69 | $870.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $128.82 Median $457.09 Typical High $691.83 | Professional | None | $128.82 | $457.09 | $691.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $138.04 Typical High $602.56 | Professional | 54 · Surgery only | $112.20 | $138.04 | $602.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.79 Typical High $67.61 | Professional | 55 · Aftercare only | $12.59 | $14.79 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $269.15 Typical High $501.19 | Professional | None | $114.82 | $269.15 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $512.86 Typical High $5,495.41 | Facility | None | $117.49 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $660.69 | Professional | None | $104.71 | $229.09 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $501.19 | Professional | 54 · Surgery only | $128.82 | $128.82 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $100.00 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $100.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $165.96 | Professional | None | $33.11 | $33.11 | $165.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $630.96 | Facility | None | $134.90 | $134.90 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $281.84 Typical High $794.33 | Professional | None | $134.90 | $281.84 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $616.60 | Professional | None | $154.88 | $208.93 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $549.54 | Facility | None | $302.00 | $309.03 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $467.74 | Professional | None | $125.89 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $91.20 Median $234.42 Typical High $512.86 | Professional | None | $91.20 | $234.42 | $512.86 |
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 $58.88 Median $85.11 Typical High $331.13 | Professional | 52 · Reduced service | $58.88 | $85.11 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $131.83 | Professional | 53 · Discontinued | $23.44 | $33.88 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $66.07 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $66.07 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $707.95 Median $1,023.29 Typical High $1,318.26 | Facility | 50 · Both sides | $707.95 | $1,023.29 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $891.25 Typical High $1,071.52 | Professional | 50 · Both sides | $190.55 | $891.25 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $169.82 Median $691.83 Typical High $812.83 | Professional | 63 · Small infant | $169.82 | $691.83 | $812.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $91.20 | $380.19 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $331.13 | Professional | 52 · Reduced service | $85.11 | $85.11 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $131.83 | Professional | 53 · Discontinued | $33.88 | $33.88 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $66.07 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $66.07 |
Where Idaho sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 25th of 51
$251
WA $447VA $107
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.