How much rates vary
Facilitymedian $912 · 10th to 90th $417 to $3,981Professionalmedian $316 · 10th to 90th $214 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 $190.55 Median $446.68 Typical High $630.96 | Professional | None | $190.55 | $446.68 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $162.18 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $32.36 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $151.36 | $316.23 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,778.28 Typical High $3,981.07 | Facility | None | $912.01 | $1,778.28 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $457.09 | Professional | None | $269.15 | $316.23 | $457.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $275.42 | $407.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $45.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $199.53 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $338.84 | Professional | None | $208.93 | $257.04 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $630.96 Typical High $5,495.41 | Facility | None | $169.82 | $630.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $630.96 | Professional | None | $223.87 | $416.87 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $162.18 | $338.84 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $32.36 | $67.61 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $151.36 | $316.23 | $436.52 |
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 $275.42 Median $275.42 Typical High $416.87 | Facility | None | $275.42 | $275.42 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $426.58 | Professional | None | $275.42 | $309.03 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $213.80 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,715.35 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $436.52 | Professional | None | $295.12 | $331.13 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $2,089.30 | Facility | None | $199.53 | $204.17 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $295.12 | Professional | None | $173.78 | $199.53 | $295.12 |
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 $165.96 Median $239.88 Typical High $398.11 | Professional | None | $165.96 | $239.88 | $398.11 |
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 $107.15 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $107.15 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $43.65 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $21.88 | $44.67 | $63.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $309.03 Median $478.63 Typical High $562.34 | Professional | 63 · Small infant | $309.03 | $478.63 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $107.15 | $223.87 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $43.65 | $91.20 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $21.88 | $44.67 | $63.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $42.66 |
Where Idaho sits
The same service costs 4.2 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· 11th of 51
$316
AK $646NJ $155
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.