How much rates vary
Facilitymedian $3,981 · 10th to 90th $513 to $17,378Professionalmedian $355 · 10th to 90th $245 to $513
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 $223.87 Median $512.86 Typical High $512.86 | Professional | None | $223.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $169.82 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $33.88 | $77.62 | $77.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $10,964.78 Typical High $20,892.96 | Facility | None | $1,819.70 | $10,964.78 | $20,892.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $398.11 | Professional | None | $331.13 | $389.05 | $398.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $5,888.44 | Facility | None | $3,890.45 | $4,365.16 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $363.08 | Professional | None | $269.15 | $331.13 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $512.86 Typical High $5,495.41 | Facility | None | $169.82 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Professional | None | $275.42 | $389.05 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $41.69 | $77.62 | $77.62 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $354.81 | Facility | None | $288.40 | $354.81 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | None | $354.81 | $354.81 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,220.18 Median $16,218.10 Typical High $22,387.21 | Facility | None | $11,220.18 | $16,218.10 | $22,387.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | None | $363.08 | $389.05 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Professional | None | $169.82 | $169.82 | $257.04 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $478.63 | Professional | None | $223.87 | $323.59 | $478.63 |
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 $112.20 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $112.20 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $45.71 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $22.39 | $51.29 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $446.68 Typical High $478.63 | Professional | 63 · Small infant | $389.05 | $446.68 | $478.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $263.03 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $263.03 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $54.95 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $27.54 | $51.29 | $51.29 |
Where Idaho sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 18th of 51
$389
TN $1,413NY $204
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.