How much rates vary
Facilitymedian $5,012 · 10th to 90th $912 to $9,550Professionalmedian $776 · 10th to 90th $355 to $2,630
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,348.96 Typical High $3,981.07 | Professional | None | $288.40 | $1,348.96 | $3,981.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $575.44 Typical High $3,019.95 | Professional | 54 · Surgery only | $309.03 | $575.44 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $114.82 Typical High $602.56 | Professional | 55 · Aftercare only | $61.66 | $114.82 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $5,248.07 Typical High $9,549.93 | Facility | None | $3,548.13 | $5,248.07 | $9,549.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $1,819.70 Typical High $2,570.40 | Professional | None | $407.38 | $1,819.70 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $2,290.87 | Professional | 54 · Surgery only | $354.81 | $436.52 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $257.04 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $1,122.02 Typical High $2,187.76 | Professional | None | $354.81 | $1,122.02 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,995.26 Typical High $5,754.40 | Facility | None | $776.25 | $1,995.26 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $776.25 Typical High $3,981.07 | Professional | None | $371.54 | $776.25 | $3,981.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $3,019.95 | Professional | 54 · Surgery only | $575.44 | $575.44 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $602.56 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $676.08 | Professional | None | $33.11 | $33.11 | $676.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $2,344.23 | Facility | None | $426.58 | $426.58 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $426.58 Median $1,412.54 Typical High $2,398.83 | Professional | None | $426.58 | $1,412.54 | $2,398.83 |
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 $478.63 Median $645.65 Typical High $2,511.89 | Professional | None | $478.63 | $645.65 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $5,370.32 | Facility | None | $1,122.02 | $1,148.15 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $1,122.02 Typical High $2,511.89 | Professional | None | $380.19 | $1,122.02 | $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 $288.40 Median $1,148.15 Typical High $2,570.40 | Professional | None | $288.40 | $1,148.15 | $2,570.40 |
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 $204.17 Median $389.05 Typical High $1,995.26 | Professional | 52 · Reduced service | $204.17 | $389.05 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $154.88 Typical High $794.33 | Professional | 53 · Discontinued | $83.18 | $154.88 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $77.62 Typical High $398.11 | Professional | 56 · Pre-op care only | $41.69 | $77.62 | $398.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $478.63 Median $562.34 Typical High $3,019.95 | Professional | 63 · Small infant | $478.63 | $562.34 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $331.13 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $275.42 | $331.13 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $1,995.26 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $794.33 | Professional | 53 · Discontinued | $154.88 | $154.88 | $794.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $398.11 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $398.11 |
Where Idaho sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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
$1,445
WI $2,089NE $447
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.