How much rates vary
Facilitymedian $3,631 · 10th to 90th $759 to $12,589Professionalmedian $661 · 10th to 90th $468 to $1,000
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 $446.68 Median $977.24 Typical High $1,348.96 | Professional | None | $446.68 | $977.24 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $724.44 Typical High $1,000.00 | Professional | 54 · Surgery only | $354.81 | $724.44 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $70.79 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $676.08 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $331.13 | $676.08 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $15,135.61 | Facility | None | $2,187.76 | $4,073.80 | $15,135.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,000.00 | Professional | None | $562.34 | $676.08 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $549.54 | $588.84 | $891.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $97.72 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $741.31 | Professional | None | $446.68 | $549.54 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $1,174.90 Typical High $5,495.41 | Facility | None | $389.05 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $870.96 Typical High $1,348.96 | Professional | None | $467.74 | $870.96 | $1,348.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $724.44 Typical High $1,000.00 | Professional | 54 · Surgery only | $354.81 | $724.44 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $70.79 | $144.54 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $676.08 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $331.13 | $676.08 | $933.25 |
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 $588.84 Median $588.84 Typical High $912.01 | Facility | None | $588.84 | $588.84 | $912.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $912.01 | Professional | None | $588.84 | $645.65 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $446.68 | $616.60 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $19,054.61 | Facility | None | $9,772.37 | $14,125.38 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $891.25 | Professional | None | $630.96 | $707.95 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $10,715.19 | Facility | None | $436.52 | $446.68 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $616.60 | Professional | None | $380.19 | $436.52 | $616.60 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $870.96 | Professional | None | $371.54 | $537.03 | $870.96 |
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 $234.42 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $234.42 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $93.33 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $97.72 Typical High $134.90 | Professional | 56 · Pre-op care only | $46.77 | $97.72 | $134.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $776.25 Typical High $1,202.26 | Professional | 63 · Small infant | $660.69 | $776.25 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $234.42 | $489.78 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $93.33 | $194.98 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $97.72 Typical High $134.90 | Professional | 56 · Pre-op care only | $46.77 | $97.72 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $87.10 |
Where Idaho sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$676
AK $1,318NJ $331
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.