How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,259 to $14,454Professionalmedian $1,259 · 10th to 90th $468 to $4,898
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 $1,258.93 Median $4,466.84 Typical High $7,762.47 | Facility | None | $1,258.93 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $6,165.95 | Professional | None | $346.74 | $1,584.89 | $6,165.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $794.33 Typical High $4,570.88 | Professional | 54 · Surgery only | $416.87 | $794.33 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $158.49 Typical High $912.01 | Professional | 55 · Aftercare only | $85.11 | $158.49 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,388.44 Median $10,471.29 Typical High $15,135.61 | Facility | None | $3,388.44 | $10,471.29 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $588.84 Median $3,467.37 Typical High $4,897.79 | Professional | None | $588.84 | $3,467.37 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $3,890.45 Typical High $4,365.16 | Professional | 54 · Surgery only | $512.86 | $3,890.45 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $69.18 Typical High $489.78 | Professional | 55 · Aftercare only | $58.88 | $69.18 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,819.70 Typical High $3,311.31 | Professional | None | $478.63 | $1,819.70 | $3,311.31 |
Hally Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,073.80 | Professional | None | $3,388.44 | $3,388.44 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,071.52 | $4,570.88 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $1,584.89 Typical High $6,165.95 | Professional | None | $446.68 | $1,584.89 | $6,165.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $4,570.88 | Professional | 54 · Surgery only | $794.33 | $794.33 | $4,570.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $912.01 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,122.02 | Professional | None | $33.11 | $33.11 | $1,122.02 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $4,466.84 | Facility | None | $616.60 | $616.60 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $2,691.53 Typical High $4,570.88 | Professional | None | $616.60 | $2,691.53 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,803.84 Typical High $17,782.79 | Facility | None | $9,332.54 | $13,803.84 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $4,073.80 | Professional | None | $676.08 | $933.25 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $7,244.36 | Facility | None | $2,137.96 | $2,187.76 | $7,244.36 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $2,137.96 Typical High $3,311.31 | Professional | None | $537.03 | $2,137.96 | $3,311.31 |
United Setting Facility Modifier None Typical Low $12,022.64 Median $26,915.35 Typical High $29,512.09 | Facility | None | $12,022.64 | $26,915.35 | $29,512.09 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $3,467.37 | Professional | None | $398.11 | $1,412.54 | $3,467.37 |
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 $281.84 Median $524.81 Typical High $3,090.30 | Professional | 52 · Reduced service | $281.84 | $524.81 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $213.80 Typical High $1,230.27 | Professional | 53 · Discontinued | $112.20 | $213.80 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $107.15 Typical High $616.60 | Professional | 56 · Pre-op care only | $56.23 | $107.15 | $616.60 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,370.32 Median $16,218.10 Typical High $22,387.21 | Facility | 50 · Both sides | $5,370.32 | $16,218.10 | $22,387.21 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $7,413.10 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $4,466.84 Typical High $5,888.44 | Professional | 63 · Small infant | $676.08 | $4,466.84 | $5,888.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $3,388.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $3,090.30 | Professional | 52 · Reduced service | $524.81 | $524.81 | $3,090.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $1,230.27 | Professional | 53 · Discontinued | $213.80 | $213.80 | $1,230.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $616.60 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $616.60 |
Where Idaho sits
The same service costs 6.3 times more in Washington 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· 18th of 51
$1,950
WA $3,236MD $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.