How much rates vary
Facilitymedian $295 · 10th to 90th $151 to $708Professionalmedian $468 · 10th to 90th $295 to $562
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 $295.12 Median $467.74 Typical High $524.81 | Professional | None | $295.12 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $43.65 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $323.59 | $371.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $204.17 Typical High $616.60 | Facility | None | $141.25 | $204.17 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $588.84 | Professional | None | $407.38 | $489.78 | $588.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $426.58 | $524.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $48.98 | $57.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $407.38 | Professional | None | $281.84 | $354.81 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $5,495.41 | Facility | None | $257.04 | $524.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $562.34 | Professional | None | $338.84 | $467.74 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $346.74 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $43.65 | $70.79 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $323.59 | $371.54 |
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 $436.52 Median $436.52 Typical High $537.03 | Facility | None | $436.52 | $436.52 | $537.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $676.08 | Professional | None | $436.52 | $537.03 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $407.38 | Facility | None | $257.04 | $263.03 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $363.08 | Professional | None | $151.36 | $257.04 | $363.08 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $512.86 | Professional | None | $245.47 | $346.74 | $512.86 |
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 $147.91 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $147.91 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $58.88 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $29.51 | $46.77 | $52.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $616.60 Typical High $724.44 | Professional | 63 · Small infant | $489.78 | $616.60 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $147.91 | $234.42 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $58.88 | $93.33 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $29.51 | $46.77 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $58.88 |
Where Idaho sits
The same service costs 5.1 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· 8th of 51
$468
AK $955UT $186
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.