How much rates vary
Facilitymedian $1,413 · 10th to 90th $234 to $2,951Professionalmedian $468 · 10th to 90th $178 to $1,230
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $602.56 Typical High $1,862.09 | Professional | None | $162.18 | $602.56 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $309.03 Typical High $1,380.38 | Professional | 54 · Surgery only | $177.83 | $309.03 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $61.66 Typical High $275.42 | Professional | 55 · Aftercare only | $35.48 | $61.66 | $275.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $2,951.21 | Facility | None | $794.33 | $1,905.46 | $2,951.21 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $831.76 Typical High $1,174.90 | Professional | None | $223.87 | $831.76 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $1,047.13 | Professional | 54 · Surgery only | $199.53 | $229.09 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $22.39 | $100.00 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $537.03 Typical High $954.99 | Professional | None | $190.55 | $537.03 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | None | $977.24 | $977.24 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $870.96 Typical High $5,495.41 | Facility | None | $169.82 | $870.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $602.56 Typical High $1,862.09 | Professional | None | $169.82 | $602.56 | $1,862.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $1,380.38 | Professional | 54 · Surgery only | $309.03 | $309.03 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $275.42 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $275.42 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $309.03 | Professional | None | $33.11 | $33.11 | $309.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $1,096.48 | Facility | None | $234.42 | $234.42 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $1,096.48 | Professional | None | $234.42 | $251.19 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $1,174.90 | Professional | None | $257.04 | $346.74 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,905.46 | Facility | None | $524.81 | $524.81 | $1,905.46 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $524.81 Typical High $812.83 | Professional | None | $204.17 | $524.81 | $812.83 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $154.88 Median $436.52 Typical High $1,148.15 | Professional | None | $154.88 | $436.52 | $1,148.15 |
10 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 $120.23 Median $208.93 Typical High $933.25 | Professional | 52 · Reduced service | $120.23 | $208.93 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $83.18 Typical High $371.54 | Professional | 53 · Discontinued | $47.86 | $83.18 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $41.69 Typical High $186.21 | Professional | 56 · Pre-op care only | $23.99 | $41.69 | $186.21 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,230.27 Median $2,818.38 Typical High $4,466.84 | Facility | 50 · Both sides | $1,230.27 | $2,818.38 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $1,548.82 Typical High $1,819.70 | Professional | 50 · Both sides | $323.59 | $1,548.82 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $257.04 Median $1,258.93 Typical High $1,479.11 | Professional | 63 · Small infant | $257.04 | $1,258.93 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $154.88 | $707.95 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $933.25 | Professional | 52 · Reduced service | $208.93 | $208.93 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $371.54 | Professional | 53 · Discontinued | $83.18 | $83.18 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $186.21 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $186.21 |
Where Idaho sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 17th of 51
$603
WI $912NE $240
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.