How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $7,244Professionalmedian $741 · 10th to 90th $501 to $1,096
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 $758.58 Median $1,071.52 Typical High $1,513.56 | Professional | None | $758.58 | $1,071.52 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $1,148.15 | Professional | 54 · Surgery only | $575.44 | $794.33 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $741.31 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $537.03 | $741.31 | $1,071.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $2,344.23 Typical High $8,317.64 | Facility | None | $1,202.26 | $2,344.23 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | None | $616.60 | $776.25 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $1,023.29 | Professional | 54 · Surgery only | $630.96 | $707.95 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | None | $457.09 | $575.44 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $1,174.90 Typical High $5,495.41 | Facility | None | $354.81 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,513.56 | Professional | None | $549.54 | $1,023.29 | $1,513.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $794.33 Typical High $1,148.15 | Professional | 54 · Surgery only | $616.60 | $794.33 | $1,148.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $741.31 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $575.44 | $741.31 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Facility | None | $645.65 | $645.65 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,047.13 | Professional | None | $645.65 | $724.44 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $512.86 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,071.52 | Professional | None | $707.95 | $758.58 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $4,897.79 | Facility | None | $489.78 | $501.19 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | None | $489.78 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $870.96 | Professional | None | $398.11 | $562.34 | $870.96 |
11 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 $380.19 Median $537.03 Typical High $758.58 | Professional | 52 · Reduced service | $380.19 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $309.03 | Professional | 53 · Discontinued | $151.36 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $107.15 Typical High $151.36 | Professional | 56 · Pre-op care only | $75.86 | $107.15 | $151.36 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $67.61 | $89.13 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $724.44 Median $1,071.52 Typical High $1,348.96 | Professional | 63 · Small infant | $724.44 | $1,071.52 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $537.03 Typical High $758.58 | Professional | 52 · Reduced service | $407.38 | $537.03 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $213.80 Typical High $309.03 | Professional | 53 · Discontinued | $165.96 | $213.80 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $123.03 | $162.18 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $107.15 Typical High $151.36 | Professional | 56 · Pre-op care only | $83.18 | $107.15 | $151.36 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $104.71 |
Where Idaho sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 10th of 51
$813
AK $1,950TX $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.