How much rates vary
Facilitymedian $275 · 10th to 90th $151 to $708Professionalmedian $309 · 10th to 90th $195 to $389
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 $190.55 Median $309.03 Typical High $363.08 | Professional | None | $190.55 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $144.54 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $134.90 | $213.80 | $257.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $707.95 | Facility | None | $141.25 | $234.42 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $416.87 | Professional | None | $275.42 | $338.84 | $416.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $251.19 | $309.03 | $380.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $41.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $223.87 | Facility | None | $147.91 | $165.96 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $281.84 | Professional | None | $186.21 | $234.42 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $363.08 Typical High $5,495.41 | Facility | None | $177.83 | $363.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $389.05 | Professional | None | $234.42 | $323.59 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $144.54 | $229.09 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $134.90 | $213.80 | $257.04 |
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 $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $478.63 | Professional | None | $302.00 | $380.19 | $478.63 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $239.88 | $288.40 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $309.03 |
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 $309.03 Median $363.08 Typical High $436.52 | Professional | None | $309.03 | $363.08 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $457.09 | Facility | None | $181.97 | $186.21 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $239.88 | Professional | None | $151.36 | $181.97 | $239.88 |
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 $162.18 Median $229.09 Typical High $338.84 | Professional | None | $162.18 | $229.09 | $338.84 |
11 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 $97.72 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $97.72 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $38.90 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $30.90 | $36.31 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $204.17 Median $323.59 Typical High $1,071.52 | Facility | 50 · Both sides | $204.17 | $323.59 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $512.86 Typical High $616.60 | Professional | 50 · Both sides | $426.58 | $512.86 | $616.60 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $407.38 Typical High $489.78 | Professional | 63 · Small infant | $331.13 | $407.38 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $97.72 | $151.36 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $38.90 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $30.90 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 50 · Both sides | $512.86 | $512.86 | $616.60 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $40.74 |
Where Idaho sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$309
AK $617FL $135
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.