How much rates vary
Facilitymedian $1,288 · 10th to 90th $631 to $2,951Professionalmedian $1,318 · 10th to 90th $933 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 $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 $933.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $933.25 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,691.53 | $3,162.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,445.44 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $147.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,148.15 | Professional | None | $891.25 | $1,023.29 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $5,495.41 | Facility | None | $831.76 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $1,737.80 | Professional | None | $933.25 | $1,513.56 | $1,737.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,754.23 | Facility | None | $1,659.59 | $2,238.72 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,479.11 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $676.08 | Facility | None | $630.96 | $630.96 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,122.02 | Professional | None | $630.96 | $724.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,584.89 | Professional | None | $812.83 | $1,096.48 | $1,584.89 |
9 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 $467.74 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $186.21 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $151.36 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $3,630.78 Typical High $4,786.30 | Facility | 50 · Both sides | $2,511.89 | $3,630.78 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,041.74 Typical High $2,238.72 | Professional | 50 · Both sides | $1,862.09 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,659.59 Typical High $1,778.28 | Professional | 63 · Small infant | $1,479.11 | $1,659.59 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $186.21 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $151.36 |
Where Idaho sits
The same service costs 4.3 times more in Alaska than in Alabama. 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.
Physician feeFacility fee
AK $6,582AL $1,537
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.