How much rates vary
Facilitymedian $295 · 10th to 90th $81 to $3,467Professionalmedian $148 · 10th to 90th $63 to $251
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 $177.83 Median $436.52 Typical High $5,495.41 | Facility | None | $177.83 | $436.52 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $147.91 Typical High $363.08 | Professional | None | $53.70 | $147.91 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $112.20 Typical High $269.15 | Professional | 54 · Surgery only | $58.88 | $112.20 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $22.39 Typical High $54.95 | Professional | 55 · Aftercare only | $11.75 | $22.39 | $54.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $2,818.38 | Facility | None | $190.55 | $371.54 | $2,818.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $239.88 | Professional | None | $77.62 | $165.96 | $239.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $77.62 | $181.97 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $7.59 | $19.05 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $208.93 | Professional | None | $69.18 | $125.89 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | None | $338.84 | $338.84 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $436.52 Typical High $4,466.84 | Facility | None | $63.10 | $436.52 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $158.49 Typical High $363.08 | Professional | None | $61.66 | $158.49 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $112.20 Typical High $269.15 | Professional | 54 · Surgery only | $93.33 | $112.20 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $54.95 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $54.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $63.10 | Professional | None | $33.11 | $33.11 | $63.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $218.78 | Facility | None | $81.28 | $81.28 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $218.78 | Professional | None | $81.28 | $89.13 | $218.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $229.09 | Professional | None | $89.13 | $120.23 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $1,096.48 | Facility | None | $104.71 | $107.15 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $162.18 | Professional | None | $72.44 | $104.71 | $162.18 |
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 $53.70 Median $131.83 Typical High $281.84 | Professional | None | $53.70 | $131.83 | $281.84 |
8 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 $39.81 Median $74.13 Typical High $181.97 | Professional | 52 · Reduced service | $39.81 | $74.13 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $29.51 Typical High $72.44 | Professional | 53 · Discontinued | $15.85 | $29.51 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $14.79 Typical High $36.31 | Professional | 56 · Pre-op care only | $7.94 | $14.79 | $36.31 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $91.20 Median $109.65 Typical High $281.84 | Professional | 63 · Small infant | $91.20 | $109.65 | $281.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $61.66 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $52.48 | $61.66 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $74.13 Typical High $181.97 | Professional | 52 · Reduced service | $61.66 | $74.13 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $72.44 | Professional | 53 · Discontinued | $25.12 | $29.51 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $36.31 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$148
WI $234FL $85.11
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.