How much rates vary
Facilitymedian $617 · 10th to 90th $200 to $7,079Professionalmedian $275 · 10th to 90th $170 to $457
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $346.74 Typical High $630.96 | Professional | None | $134.90 | $346.74 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $1,230.27 Typical High $8,317.64 | Facility | None | $223.87 | $1,230.27 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $457.09 | Professional | None | $204.17 | $323.59 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $281.84 | Facility | None | $181.97 | $204.17 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $338.84 | Professional | None | $169.82 | $239.88 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $512.86 Typical High $5,495.41 | Facility | None | $114.82 | $512.86 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $630.96 | Professional | None | $186.21 | $354.81 | $630.96 |
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 $223.87 Median $223.87 Typical High $416.87 | Facility | None | $223.87 | $223.87 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $426.58 | Professional | None | $223.87 | $275.42 | $426.58 |
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 $234.42 Median $263.03 Typical High $436.52 | Professional | None | $234.42 | $263.03 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $4,897.79 | Facility | None | $199.53 | $204.17 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $269.15 | Professional | None | $141.25 | $199.53 | $269.15 |
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 $134.90 Median $229.09 Typical High $389.05 | Professional | None | $134.90 | $229.09 | $389.05 |
16 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 $87.10 Median $177.83 Typical High $316.23 | Professional | 52 · Reduced service | $87.10 | $177.83 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $70.79 Typical High $125.89 | Professional | 53 · Discontinued | $34.67 | $70.79 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $269.15 Typical High $478.63 | Professional | 54 · Surgery only | $131.83 | $269.15 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $53.70 Typical High $95.50 | Professional | 55 · Aftercare only | $26.30 | $53.70 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $35.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.38 | $35.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $251.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $123.03 | $251.19 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $186.21 | $346.74 | $426.58 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $44.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $288.40 Typical High $512.86 | Professional | 63 · Small infant | $245.47 | $288.40 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $169.82 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $144.54 | $169.82 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $177.83 Typical High $316.23 | Professional | 52 · Reduced service | $87.10 | $177.83 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $70.79 Typical High $125.89 | Professional | 53 · Discontinued | $34.67 | $70.79 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $269.15 Typical High $478.63 | Professional | 54 · Surgery only | $131.83 | $269.15 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $53.70 Typical High $95.50 | Professional | 55 · Aftercare only | $26.30 | $53.70 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $35.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.38 | $35.48 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $251.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $123.03 | $251.19 | $446.68 |
Where Idaho sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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
$302
WI $631KY $166
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.