How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,202 to $7,762Professionalmedian $1,349 · 10th to 90th $912 to $1,660
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,513.56 | Professional | None | $912.01 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $676.08 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $630.96 | $1,071.52 | $1,071.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $8,511.38 | Facility | None | $1,621.81 | $2,570.40 | $8,511.38 |
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 $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $891.25 | $1,047.13 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $5,495.41 | Facility | None | $676.08 | $1,513.56 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,778.28 | Professional | None | $912.01 | $1,513.56 | $1,778.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $676.08 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $630.96 | $1,071.52 | $1,071.52 |
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 $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 $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,445.44 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $4,168.69 | Facility | None | $630.96 | $645.65 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,862.09 | Professional | None | $630.96 | $741.31 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,584.89 | Professional | None | $794.33 | $1,071.52 | $1,584.89 |
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 $457.09 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $457.09 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $181.97 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $91.20 | $151.36 | $151.36 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $851.14 Typical High $933.25 | Professional | 62 · Two surgeons | $758.58 | $851.14 | $933.25 |
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 $457.09 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $457.09 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $181.97 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $91.20 | $151.36 | $151.36 |
Where Idaho sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$1,380
AK $2,951UT $447
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.