How much rates vary
Facilitymedian $550 · 10th to 90th $166 to $2,344Professionalmedian $240 · 10th to 90th $115 to $417
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 $109.65 Median $239.88 Typical High $562.34 | Professional | None | $109.65 | $239.88 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $181.97 Typical High $426.58 | Professional | 54 · Surgery only | $83.18 | $181.97 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $36.31 Typical High $85.11 | Professional | 55 · Aftercare only | $16.60 | $36.31 | $85.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $2,344.23 | Facility | None | $181.97 | $645.65 | $2,344.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $416.87 | Professional | None | $131.83 | $263.03 | $416.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $371.54 | Professional | 54 · Surgery only | $114.82 | $144.54 | $371.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.85 Typical High $42.66 | Professional | 55 · Aftercare only | $12.88 | $15.85 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $173.78 Typical High $234.42 | Facility | None | $154.88 | $173.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $309.03 | Professional | None | $114.82 | $204.17 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $346.74 Typical High $5,495.41 | Facility | None | $109.65 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $562.34 | Professional | None | $112.20 | $239.88 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $181.97 Typical High $426.58 | Professional | 54 · Surgery only | $83.18 | $181.97 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $36.31 Typical High $85.11 | Professional | 55 · Aftercare only | $16.60 | $36.31 | $85.11 |
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 $134.90 Median $134.90 Typical High $380.19 | Facility | None | $134.90 | $134.90 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $380.19 | Professional | None | $134.90 | $158.49 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $257.04 | Professional | 54 · Surgery only | $112.20 | $112.20 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,584.89 | $2,041.74 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $380.19 | Professional | None | $158.49 | $204.17 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $186.21 | Facility | None | $181.97 | $181.97 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $239.88 | Professional | None | $85.11 | $181.97 | $239.88 |
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 $91.20 Median $181.97 Typical High $331.13 | Professional | None | $91.20 | $181.97 | $331.13 |
10 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 $54.95 Median $120.23 Typical High $281.84 | Professional | 52 · Reduced service | $54.95 | $120.23 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $47.86 Typical High $112.20 | Professional | 53 · Discontinued | $21.88 | $47.86 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $23.99 Typical High $56.23 | Professional | 56 · Pre-op care only | $10.96 | $23.99 | $56.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $147.91 Median $426.58 Typical High $512.86 | Professional | 63 · Small infant | $147.91 | $426.58 | $512.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $120.23 Typical High $281.84 | Professional | 52 · Reduced service | $54.95 | $120.23 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $47.86 Typical High $112.20 | Professional | 53 · Discontinued | $21.88 | $47.86 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $23.99 Typical High $56.23 | Professional | 56 · Pre-op care only | $10.96 | $23.99 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $37.15 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $275.42 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$240
AK $355MD $95.50
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.