How much rates vary
Facilitymedian $1,862 · 10th to 90th $562 to $5,495Professionalmedian $977 · 10th to 90th $427 to $4,169
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 $346.74 Median $1,905.46 Typical High $5,495.41 | Professional | None | $346.74 | $1,905.46 | $5,495.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $724.44 Typical High $4,073.80 | Professional | 54 · Surgery only | $380.19 | $724.44 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $144.54 Typical High $812.83 | Professional | 55 · Aftercare only | $75.86 | $144.54 | $812.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $3,801.89 | Facility | None | $1,122.02 | $1,862.09 | $3,801.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $2,089.30 Typical High $4,168.69 | Professional | None | $537.03 | $2,089.30 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $3,162.28 Typical High $3,715.35 | Professional | 54 · Surgery only | $489.78 | $3,162.28 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $416.87 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,584.89 Typical High $3,019.95 | Professional | None | $446.68 | $1,584.89 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,570.40 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $3,467.37 Typical High $7,244.36 | Facility | None | $389.05 | $3,467.37 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $1,995.26 Typical High $5,495.41 | Professional | None | $407.38 | $1,995.26 | $5,495.41 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $4,073.80 | Professional | 54 · Surgery only | $724.44 | $724.44 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $812.83 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,000.00 | Professional | None | $33.11 | $33.11 | $1,000.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $3,801.89 | Facility | None | $562.34 | $562.34 | $3,801.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $3,801.89 | Professional | None | $562.34 | $660.69 | $3,801.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $3,548.13 | Professional | None | $616.60 | $851.14 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $1,862.09 | Facility | None | $1,174.90 | $1,819.70 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $1,819.70 Typical High $2,818.38 | Professional | None | $489.78 | $1,819.70 | $2,818.38 |
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 $363.08 Median $1,230.27 Typical High $3,801.89 | Professional | None | $363.08 | $1,230.27 | $3,801.89 |
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 $251.19 Median $489.78 Typical High $2,754.23 | Professional | 52 · Reduced service | $251.19 | $489.78 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $194.98 Typical High $1,096.48 | Professional | 53 · Discontinued | $100.00 | $194.98 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $97.72 Typical High $549.54 | Professional | 56 · Pre-op care only | $50.12 | $97.72 | $549.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $758.58 Typical High $5,011.87 | Professional | 63 · Small infant | $630.96 | $758.58 | $5,011.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $2,754.23 | Professional | 52 · Reduced service | $489.78 | $489.78 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $1,096.48 | Professional | 53 · Discontinued | $194.98 | $194.98 | $1,096.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $549.54 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $549.54 |
Where Idaho sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 27th of 51
$1,585
WA $2,818KY $513
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.