How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,549 to $16,596Professionalmedian $1,096 · 10th to 90th $501 to $4,169
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 $416.87 Median $2,041.74 Typical High $6,309.57 | Professional | None | $416.87 | $2,041.74 | $6,309.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $812.83 Typical High $4,677.35 | Professional | 54 · Surgery only | $426.58 | $812.83 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $162.18 Typical High $933.25 | Professional | 55 · Aftercare only | $87.10 | $162.18 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,715.35 Median $6,918.31 Typical High $16,595.87 | Facility | None | $3,715.35 | $6,918.31 | $16,595.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $2,818.38 Typical High $3,981.07 | Professional | None | $575.44 | $2,818.38 | $3,981.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $3,162.28 Typical High $3,715.35 | Professional | 54 · Surgery only | $501.19 | $3,162.28 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $416.87 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $954.99 Typical High $3,388.44 | Professional | None | $501.19 | $954.99 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | None | $2,454.71 | $2,454.71 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,096.48 | $3,162.28 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $2,089.30 Typical High $6,309.57 | Professional | None | $501.19 | $2,089.30 | $6,309.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $4,677.35 | Professional | 54 · Surgery only | $812.83 | $812.83 | $4,677.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $933.25 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $933.25 |
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 $3,630.78 | Facility | None | $602.56 | $602.56 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,715.35 | Professional | None | $602.56 | $2,187.76 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $17,782.79 | Facility | None | $9,332.54 | $13,182.57 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $3,890.45 | Professional | None | $660.69 | $891.25 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,737.80 | $1,778.28 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $1,737.80 Typical High $3,981.07 | Professional | None | $537.03 | $1,737.80 | $3,981.07 |
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 $1,621.81 Typical High $4,073.80 | Professional | None | $389.05 | $1,621.81 | $4,073.80 |
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 $288.40 Median $537.03 Typical High $3,162.28 | Professional | 52 · Reduced service | $288.40 | $537.03 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $218.78 Typical High $1,258.93 | Professional | 53 · Discontinued | $114.82 | $218.78 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $109.65 Typical High $630.96 | Professional | 56 · Pre-op care only | $57.54 | $109.65 | $630.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $741.31 Median $3,981.07 Typical High $4,786.30 | Professional | 63 · Small infant | $741.31 | $3,981.07 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $2,754.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $3,162.28 | Professional | 52 · Reduced service | $537.03 | $537.03 | $3,162.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $1,258.93 | Professional | 53 · Discontinued | $218.78 | $218.78 | $1,258.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $630.96 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $630.96 |
Where Idaho sits
The same service costs 6.9 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· 13th of 51
$2,291
WI $3,162HI $457
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.