How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,349 to $9,550Professionalmedian $1,122 · 10th to 90th $427 to $3,715
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 $1,412.54 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,412.54 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,479.11 Typical High $4,677.35 | Professional | None | $309.03 | $1,479.11 | $4,677.35 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $707.95 Typical High $3,467.37 | Professional | 54 · Surgery only | $371.54 | $707.95 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $141.25 Typical High $691.83 | Professional | 55 · Aftercare only | $74.13 | $141.25 | $691.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,995.26 Median $6,025.60 Typical High $8,511.38 | Facility | None | $1,995.26 | $6,025.60 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $2,630.27 Typical High $3,715.35 | Professional | None | $524.81 | $2,630.27 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $3,162.28 | Professional | 54 · Surgery only | $457.09 | $537.03 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $288.40 Typical High $371.54 | Professional | 55 · Aftercare only | $50.12 | $288.40 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,412.54 Typical High $2,454.71 | Professional | None | $426.58 | $1,412.54 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,162.28 | Professional | None | $3,090.30 | $3,090.30 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $3,890.45 Typical High $6,918.31 | Facility | None | $933.25 | $3,890.45 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $1,479.11 Typical High $4,677.35 | Professional | None | $436.52 | $1,479.11 | $4,677.35 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $3,467.37 | Professional | 54 · Surgery only | $707.95 | $707.95 | $3,467.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $691.83 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $870.96 | Professional | None | $33.11 | $33.11 | $870.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $3,467.37 | Facility | None | $549.54 | $549.54 | $3,467.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $549.54 Median $2,041.74 Typical High $3,467.37 | Professional | None | $549.54 | $2,041.74 | $3,467.37 |
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 $588.84 Median $831.76 Typical High $3,162.28 | Professional | None | $588.84 | $831.76 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $4,265.80 | Facility | None | $1,621.81 | $1,659.59 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $1,621.81 Typical High $2,511.89 | Professional | None | $478.63 | $1,621.81 | $2,511.89 |
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 $346.74 Median $1,258.93 Typical High $2,818.38 | Professional | None | $346.74 | $1,258.93 | $2,818.38 |
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 $245.47 Median $467.74 Typical High $2,344.23 | Professional | 52 · Reduced service | $245.47 | $467.74 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $186.21 Typical High $933.25 | Professional | 53 · Discontinued | $100.00 | $186.21 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $93.33 Typical High $467.74 | Professional | 56 · Pre-op care only | $50.12 | $93.33 | $467.74 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,466.84 Median $9,120.11 Typical High $12,589.25 | Facility | 50 · Both sides | $4,466.84 | $9,120.11 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $891.25 Typical High $5,754.40 | Professional | 50 · Both sides | $758.58 | $891.25 | $5,754.40 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $602.56 Median $707.95 Typical High $4,466.84 | Professional | 63 · Small infant | $602.56 | $707.95 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $2,238.72 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $354.81 | $2,238.72 | $2,691.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $2,344.23 | Professional | 52 · Reduced service | $467.74 | $467.74 | $2,344.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $933.25 | Professional | 53 · Discontinued | $186.21 | $186.21 | $933.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $467.74 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $467.74 |
Where Idaho sits
The same service costs 5.6 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· 15th of 51
$1,622
WI $2,570MD $457
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.