How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,318 to $7,762Professionalmedian $1,259 · 10th to 90th $794 to $1,445
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 $4,677.35 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $1,288.25 | Professional | None | $724.44 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $8,511.38 | Facility | None | $2,089.30 | $3,630.78 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,258.93 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,122.02 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $128.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $912.01 |
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 $758.58 Median $870.96 Typical High $1,000.00 | Professional | None | $758.58 | $870.96 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,698.24 Typical High $5,495.41 | Facility | None | $660.69 | $1,698.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,513.56 | Professional | None | $812.83 | $1,288.25 | $1,513.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $123.03 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
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 $933.25 Median $1,318.26 Typical High $1,318.26 | Facility | None | $933.25 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,318.26 | $1,513.56 |
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 $1,174.90 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,288.25 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $6,456.54 | Facility | None | $549.54 | $562.34 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,862.09 | Professional | None | $549.54 | $645.65 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,412.54 | $1,819.70 | $3,235.94 |
United Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,348.96 | Professional | None | $676.08 | $912.01 | $1,348.96 |
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 $407.38 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $162.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $81.28 | $128.82 | $128.82 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,090.30 Median $5,011.87 Typical High $12,589.25 | Facility | 50 · Both sides | $3,090.30 | $5,011.87 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,862.09 Typical High $1,949.84 | Professional | 50 · Both sides | $1,621.81 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,288.25 Median $1,479.11 Typical High $1,548.82 | Professional | 63 · Small infant | $1,288.25 | $1,479.11 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $407.38 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $162.18 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $81.28 | $128.82 | $128.82 |
Where Idaho sits
The same service costs 7.4 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· 7th of 51
$1,288
AK $2,630TX $355
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.