How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,288 to $10,965Professionalmedian $1,288 · 10th to 90th $891 to $1,585
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,630.78 Typical High $12,022.64 | Facility | None | $2,187.76 | $3,630.78 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,412.54 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,467.37 | Facility | None | $2,290.87 | $2,570.40 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,122.02 | Professional | None | $794.33 | $1,000.00 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $5,495.41 | Facility | None | $776.25 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $933.25 | $1,479.11 | $1,737.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $138.04 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,023.29 |
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 $1,047.13 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,047.13 | $1,288.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $645.65 | Facility | None | $616.60 | $616.60 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $2,344.23 | Professional | None | $616.60 | $724.44 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,445.44 | Professional | None | $691.83 | $977.24 | $1,445.44 |
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 $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $186.21 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,162.28 Median $6,025.60 Typical High $18,197.01 | Facility | 50 · Both sides | $3,162.28 | $6,025.60 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,995.26 Typical High $2,187.76 | Professional | 50 · Both sides | $1,778.28 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $831.76 Typical High $912.01 | Professional | 62 · Two surgeons | $741.31 | $831.76 | $912.01 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | 63 · Small infant | $1,445.44 | $1,621.81 | $1,737.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $186.21 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $93.33 | $147.91 | $147.91 |
Where Idaho sits
The same service costs 7.6 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· 9th of 51
$1,349
AK $2,951TX $389
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.