How much rates vary
Facilitymedian $2,042 · 10th to 90th $891 to $7,762Professionalmedian $1,023 · 10th to 90th $692 to $1,349
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,348.96 | Professional | None | $616.60 | $1,023.29 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $8,511.38 | Facility | None | $1,621.81 | $2,691.53 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,380.38 | Professional | None | $831.76 | $1,096.48 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $741.31 | $1,096.48 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $831.76 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $602.56 | $831.76 | $977.24 |
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 $645.65 Median $776.25 Typical High $1,047.13 | Professional | None | $645.65 | $776.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,495.41 | Facility | None | $602.56 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,348.96 | Professional | None | $741.31 | $1,071.52 | $1,348.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $758.58 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $707.95 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $426.58 | $707.95 | $954.99 |
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 $891.25 Median $891.25 Typical High $1,288.25 | Facility | None | $891.25 | $891.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,096.48 |
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 $977.24 Median $1,202.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,202.26 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $4,168.69 | Facility | None | $602.56 | $616.60 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,862.09 | Professional | None | $501.19 | $602.56 | $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 $537.03 Median $812.83 Typical High $1,318.26 | Professional | None | $537.03 | $812.83 | $1,318.26 |
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 $309.03 Median $512.86 Typical High $676.08 | Professional | 52 · Reduced service | $309.03 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $269.15 | Professional | 53 · Discontinued | $123.03 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $134.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,000.00 Median $1,380.38 Typical High $1,659.59 | Professional | 63 · Small infant | $1,000.00 | $1,380.38 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $512.86 Typical High $676.08 | Professional | 52 · Reduced service | $309.03 | $512.86 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $204.17 Typical High $269.15 | Professional | 53 · Discontinued | $123.03 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $147.91 |
Where Idaho sits
The same service costs 5.8 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· 10th of 51
$1,023
AK $2,455TX $427
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.