How much rates vary
Facilitymedian $562 · 10th to 90th $166 to $7,244Professionalmedian $240 · 10th to 90th $151 to $398
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 $117.49 Median $323.59 Typical High $549.54 | Professional | None | $117.49 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $407.38 | Professional | 54 · Surgery only | $114.82 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $81.28 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $1,230.27 Typical High $8,317.64 | Facility | None | $177.83 | $1,230.27 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $398.11 | Professional | None | $190.55 | $251.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $199.53 Typical High $354.81 | Professional | 54 · Surgery only | $162.18 | $199.53 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $39.81 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $39.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $141.25 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $295.12 | Professional | None | $151.36 | $204.17 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $457.09 Typical High $5,495.41 | Facility | None | $125.89 | $457.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $549.54 | Professional | None | $154.88 | $323.59 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $239.88 Typical High $407.38 | Professional | 54 · Surgery only | $114.82 | $239.88 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $47.86 Typical High $81.28 | Professional | 55 · Aftercare only | $22.91 | $47.86 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $223.87 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $107.15 | $223.87 | $380.19 |
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 $194.98 Median $194.98 Typical High $363.08 | Facility | None | $194.98 | $194.98 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $371.54 | Professional | None | $194.98 | $218.78 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | 54 · Surgery only | $151.36 | $151.36 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $275.42 |
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 $213.80 Median $257.04 Typical High $380.19 | Professional | None | $213.80 | $257.04 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $3,235.94 | Facility | None | $173.78 | $177.83 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $234.42 | Professional | None | $123.03 | $173.78 | $234.42 |
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 $117.49 Median $190.55 Typical High $323.59 | Professional | None | $117.49 | $190.55 | $323.59 |
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 $77.62 Median $158.49 Typical High $275.42 | Professional | 52 · Reduced service | $77.62 | $158.49 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $30.90 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $32.36 Typical High $54.95 | Professional | 56 · Pre-op care only | $15.49 | $32.36 | $54.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $263.03 Typical High $478.63 | Professional | 63 · Small infant | $239.88 | $263.03 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $158.49 Typical High $275.42 | Professional | 52 · Reduced service | $77.62 | $158.49 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $64.57 Typical High $109.65 | Professional | 53 · Discontinued | $30.90 | $64.57 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $32.36 Typical High $54.95 | Professional | 56 · Pre-op care only | $15.49 | $32.36 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $37.15 |
Where Idaho sits
The same service costs 3.4 times more in Alaska 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· 9th of 51
$251
AK $447FL $132
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.