How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,259 to $15,136Professionalmedian $1,259 · 10th to 90th $468 to $4,786
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 $5,888.44 | Professional | None | $346.74 | $1,584.89 | $5,888.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $794.33 Typical High $4,466.84 | Professional | 54 · Surgery only | $416.87 | $794.33 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $158.49 Typical High $891.25 | Professional | 55 · Aftercare only | $83.18 | $158.49 | $891.25 |
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 $575.44 Median $3,388.44 Typical High $4,786.30 | Professional | None | $575.44 | $3,388.44 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $4,466.84 | Professional | 54 · Surgery only | $501.19 | $602.56 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $338.84 Typical High $467.74 | Professional | 55 · Aftercare only | $56.23 | $338.84 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $1,778.28 Typical High $3,162.28 | Professional | None | $478.63 | $1,778.28 | $3,162.28 |
Hally Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $5,495.41 Typical High $9,772.37 | Facility | None | $1,047.13 | $5,495.41 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $1,737.80 Typical High $5,888.44 | Professional | None | $457.09 | $1,737.80 | $5,888.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $4,466.84 | Professional | 54 · Surgery only | $794.33 | $794.33 | $4,466.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $891.25 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,071.52 | Professional | None | $33.11 | $33.11 | $1,071.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $4,365.16 | Facility | None | $602.56 | $602.56 | $4,365.16 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $2,630.27 Typical High $4,365.16 | Professional | None | $602.56 | $2,630.27 | $4,365.16 |
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 $660.69 Median $933.25 Typical High $3,981.07 | Professional | None | $660.69 | $933.25 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $7,244.36 | Facility | None | $2,089.30 | $2,137.96 | $7,244.36 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $2,089.30 Typical High $3,235.94 | Professional | None | $537.03 | $2,089.30 | $3,235.94 |
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 $389.05 Median $1,412.54 Typical High $3,311.31 | Professional | None | $389.05 | $1,412.54 | $3,311.31 |
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 $275.42 Median $524.81 Typical High $2,951.21 | Professional | 52 · Reduced service | $275.42 | $524.81 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $208.93 Typical High $1,174.90 | Professional | 53 · Discontinued | $112.20 | $208.93 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $104.71 Typical High $588.84 | Professional | 56 · Pre-op care only | $56.23 | $104.71 | $588.84 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,011.87 Median $15,848.93 Typical High $22,387.21 | Facility | 50 · Both sides | $5,011.87 | $15,848.93 | $22,387.21 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $5,495.41 Typical High $7,079.46 | Professional | 50 · Both sides | $851.14 | $5,495.41 | $7,079.46 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $3,981.07 Typical High $5,754.40 | Professional | 63 · Small infant | $676.08 | $3,981.07 | $5,754.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $3,311.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $2,951.21 | Professional | 52 · Reduced service | $524.81 | $524.81 | $2,951.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $1,174.90 | Professional | 53 · Discontinued | $208.93 | $208.93 | $1,174.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $588.84 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $588.84 |
Where Idaho sits
The same service costs 6.2 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· 12th of 51
$1,995
WA $3,162MD $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.