How much rates vary
Facilitymedian $2,344 · 10th to 90th $575 to $4,571Professionalmedian $813 · 10th to 90th $302 to $2,570
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 $851.14 Median $4,466.84 Typical High $5,495.41 | Facility | None | $851.14 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,122.02 Typical High $3,890.45 | Professional | None | $263.03 | $1,122.02 | $3,890.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $537.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $288.40 | $537.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $107.15 Typical High $575.44 | Professional | 55 · Aftercare only | $57.54 | $107.15 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $3,090.30 Typical High $4,073.80 | Facility | None | $1,412.54 | $3,090.30 | $4,073.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $380.19 Median $1,778.28 Typical High $2,511.89 | Professional | None | $380.19 | $1,778.28 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $2,238.72 | Professional | 54 · Surgery only | $371.54 | $398.11 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $245.47 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,096.48 Typical High $2,089.30 | Professional | None | $323.59 | $1,096.48 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,698.24 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $3,890.45 Typical High $5,754.40 | Facility | None | $295.12 | $3,890.45 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $1,174.90 Typical High $3,890.45 | Professional | None | $295.12 | $1,174.90 | $3,890.45 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $575.44 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $660.69 | Professional | None | $33.11 | $33.11 | $660.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $2,290.87 | Facility | None | $398.11 | $398.11 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $2,344.23 | Professional | None | $398.11 | $446.68 | $2,344.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $2,454.71 | Professional | None | $436.52 | $588.84 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,122.02 | Facility | None | $660.69 | $1,096.48 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $1,096.48 Typical High $1,698.24 | Professional | None | $354.81 | $1,096.48 | $1,698.24 |
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 $263.03 Median $870.96 Typical High $2,238.72 | Professional | None | $263.03 | $870.96 | $2,238.72 |
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 $190.55 Median $354.81 Typical High $1,949.84 | Professional | 52 · Reduced service | $190.55 | $354.81 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $141.25 Typical High $776.25 | Professional | 53 · Discontinued | $75.86 | $141.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $70.79 Typical High $389.05 | Professional | 56 · Pre-op care only | $38.02 | $70.79 | $389.05 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $4,677.35 Typical High $6,165.95 | Facility | 50 · Both sides | $2,344.23 | $4,677.35 | $6,165.95 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $3,235.94 Typical High $3,890.45 | Professional | 50 · Both sides | $575.44 | $3,235.94 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $457.09 Median $2,511.89 Typical High $3,090.30 | Professional | 63 · Small infant | $457.09 | $2,511.89 | $3,090.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $1,949.84 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $776.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $776.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $389.05 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $389.05 |
Where Idaho sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 22nd of 51
$1,122
WA $1,820HI $316
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.