How much rates vary
Facilitymedian $1,549 · 10th to 90th $417 to $5,495Professionalmedian $851 · 10th to 90th $324 to $1,778
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 $891.25 Median $1,621.81 Typical High $5,495.41 | Facility | None | $891.25 | $1,621.81 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $891.25 Typical High $2,570.40 | Professional | None | $288.40 | $891.25 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $562.34 Typical High $1,949.84 | Professional | 54 · Surgery only | $316.23 | $562.34 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $112.20 Typical High $389.05 | Professional | 55 · Aftercare only | $63.10 | $112.20 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,137.96 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $398.11 Median $1,174.90 Typical High $1,659.59 | Professional | None | $398.11 | $1,174.90 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $416.87 Typical High $1,548.82 | Professional | 54 · Surgery only | $346.74 | $416.87 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $38.90 | $141.25 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $812.83 Typical High $1,412.54 | Professional | None | $346.74 | $812.83 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,412.54 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $1,230.27 Typical High $4,466.84 | Facility | None | $323.59 | $1,230.27 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $891.25 Typical High $2,570.40 | Professional | None | $309.03 | $891.25 | $2,570.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,949.84 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $389.05 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $436.52 | Professional | None | $33.11 | $33.11 | $436.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,548.82 | Facility | None | $416.87 | $416.87 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $1,548.82 | Professional | None | $416.87 | $457.09 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,621.81 | Professional | None | $467.74 | $630.96 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $741.31 Typical High $6,309.57 | Facility | None | $724.44 | $741.31 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $1,122.02 | Professional | None | $371.54 | $724.44 | $1,122.02 |
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 $281.84 Median $707.95 Typical High $1,778.28 | Professional | None | $281.84 | $707.95 | $1,778.28 |
9 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 $208.93 Median $380.19 Typical High $1,288.25 | Professional | 52 · Reduced service | $208.93 | $380.19 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $151.36 Typical High $512.86 | Professional | 53 · Discontinued | $83.18 | $151.36 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $75.86 Typical High $257.04 | Professional | 56 · Pre-op care only | $41.69 | $75.86 | $257.04 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $2,137.96 Typical High $2,511.89 | Professional | 50 · Both sides | $602.56 | $2,137.96 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $537.03 Median $1,737.80 Typical High $1,995.26 | Professional | 63 · Small infant | $537.03 | $1,737.80 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $281.84 | $1,000.00 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $1,288.25 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $512.86 | Professional | 53 · Discontinued | $151.36 | $151.36 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $257.04 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $257.04 |
Where Idaho sits
The same service costs 4.3 times more in Wisconsin 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· 15th of 51
$891
WI $1,380HI $324
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.