How much rates vary
Facilitymedian $1,549 · 10th to 90th $468 to $4,467Professionalmedian $813 · 10th to 90th $363 to $2,344
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 $288.40 Median $1,148.15 Typical High $3,311.31 | Professional | None | $288.40 | $1,148.15 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $602.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $316.23 | $602.56 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $120.23 Typical High $489.78 | Professional | 55 · Aftercare only | $63.10 | $120.23 | $489.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,047.13 | $1,548.82 | $3,311.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $446.68 Median $1,584.89 Typical High $2,238.72 | Professional | None | $446.68 | $1,584.89 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $2,089.30 | Professional | 54 · Surgery only | $389.05 | $457.09 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $47.86 | $190.55 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,047.13 Typical High $1,778.28 | Professional | None | $371.54 | $1,047.13 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,949.84 | $1,949.84 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $3,162.28 Typical High $5,495.41 | Facility | None | $323.59 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $1,202.26 Typical High $3,311.31 | Professional | None | $398.11 | $1,202.26 | $3,311.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $602.56 | $602.56 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $489.78 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $575.44 | Professional | None | $33.11 | $33.11 | $575.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $2,089.30 | Facility | None | $467.74 | $467.74 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $2,089.30 | Professional | None | $467.74 | $489.78 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $2,089.30 | Professional | None | $501.19 | $691.83 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Facility | None | $1,000.00 | $1,000.00 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $1,000.00 Typical High $1,548.82 | Professional | None | $398.11 | $1,000.00 | $1,548.82 |
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 $302.00 Median $776.25 Typical High $2,290.87 | Professional | None | $302.00 | $776.25 | $2,290.87 |
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 $213.80 Median $407.38 Typical High $1,659.59 | Professional | 52 · Reduced service | $213.80 | $407.38 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $660.69 | Professional | 53 · Discontinued | $85.11 | $162.18 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $331.13 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $331.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $512.86 Median $2,290.87 Typical High $2,818.38 | Professional | 63 · Small infant | $512.86 | $2,290.87 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $309.03 | $1,348.96 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $1,659.59 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $660.69 | Professional | 53 · Discontinued | $162.18 | $162.18 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $331.13 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $331.13 |
Where Idaho sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 21st of 51
$1,047
WI $1,660MD $468
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.