How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $9,550Professionalmedian $603 · 10th to 90th $275 to $2,042
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 $218.78 Median $1,023.29 Typical High $3,090.30 | Professional | None | $218.78 | $1,023.29 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $446.68 Typical High $2,290.87 | Professional | 54 · Surgery only | $239.88 | $446.68 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $89.13 Typical High $457.09 | Professional | 55 · Aftercare only | $47.86 | $89.13 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $6,309.57 Typical High $8,511.38 | Facility | None | $2,041.74 | $6,309.57 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $1,412.54 Typical High $1,995.26 | Professional | None | $323.59 | $1,412.54 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $1,778.28 | Professional | 54 · Surgery only | $281.84 | $338.84 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $30.90 | $169.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $870.96 Typical High $1,659.59 | Professional | None | $275.42 | $870.96 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,584.89 | $1,584.89 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $5,495.41 | Facility | None | $602.56 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $602.56 Typical High $3,090.30 | Professional | None | $275.42 | $602.56 | $3,090.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $2,290.87 | Professional | 54 · Surgery only | $446.68 | $446.68 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $457.09 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $457.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $524.81 | Professional | None | $33.11 | $33.11 | $524.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $1,819.70 | Facility | None | $338.84 | $338.84 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $1,096.48 Typical High $1,819.70 | Professional | None | $338.84 | $1,096.48 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,495.41 | $7,943.28 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $1,949.84 | Professional | None | $371.54 | $501.19 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $870.96 Typical High $1,348.96 | Professional | None | $295.12 | $870.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $9,549.93 Median $16,982.44 Typical High $18,197.01 | Facility | None | $9,549.93 | $16,982.44 | $18,197.01 |
United Setting Professional Modifier None Typical Low $223.87 Median $870.96 Typical High $2,041.74 | Professional | None | $223.87 | $870.96 | $2,041.74 |
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 $158.49 Median $302.00 Typical High $1,548.82 | Professional | 52 · Reduced service | $158.49 | $302.00 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $120.23 Typical High $616.60 | Professional | 53 · Discontinued | $63.10 | $120.23 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $60.26 Typical High $309.03 | Professional | 56 · Pre-op care only | $31.62 | $60.26 | $309.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $371.54 Median $2,089.30 Typical High $2,454.71 | Professional | 63 · Small infant | $371.54 | $2,089.30 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $263.03 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $223.87 | $263.03 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $1,548.82 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $616.60 | Professional | 53 · Discontinued | $120.23 | $120.23 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $309.03 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $309.03 |
Where Idaho sits
The same service costs 5.9 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· 14th of 51
$1,122
WI $1,622MD $275
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.