How much rates vary
Facilitymedian $891 · 10th to 90th $550 to $3,090Professionalmedian $245 · 10th to 90th $117 to $2,138
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 $114.82 Median $870.96 Typical High $2,818.38 | Professional | None | $114.82 | $870.96 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $602.56 Typical High $2,137.96 | Professional | 54 · Surgery only | $85.11 | $602.56 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $120.23 Typical High $426.58 | Professional | 55 · Aftercare only | $17.38 | $120.23 | $426.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $3,090.30 | Facility | None | $741.31 | $1,174.90 | $3,090.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $1,348.96 Typical High $2,137.96 | Professional | None | $147.91 | $1,348.96 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $1,621.81 Typical High $1,949.84 | Professional | 54 · Surgery only | $131.83 | $1,621.81 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $213.80 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $213.80 |
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 $117.49 Median $245.47 Typical High $1,584.89 | Professional | None | $117.49 | $245.47 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,412.54 Typical High $4,466.84 | Facility | None | $245.47 | $1,412.54 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $457.09 Typical High $2,818.38 | Professional | None | $131.83 | $457.09 | $2,818.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $338.84 Typical High $2,137.96 | Professional | 54 · Surgery only | $85.11 | $338.84 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $67.61 Typical High $426.58 | Professional | 55 · Aftercare only | $17.38 | $67.61 | $426.58 |
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 $154.88 Median $154.88 Typical High $1,995.26 | Facility | None | $154.88 | $154.88 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $398.11 Typical High $1,995.26 | Professional | None | $154.88 | $398.11 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $186.21 Typical High $1,258.93 | Professional | 54 · Surgery only | $114.82 | $186.21 | $1,258.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Facility | None | $1,995.26 | $2,630.27 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $1,862.09 | Professional | None | $162.18 | $213.80 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $2,041.74 | Facility | None | $933.25 | $954.99 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $933.25 Typical High $1,122.02 | Professional | None | $97.72 | $933.25 | $1,122.02 |
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 $93.33 Median $707.95 Typical High $1,698.24 | Professional | None | $93.33 | $707.95 | $1,698.24 |
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 $57.54 Median $398.11 Typical High $1,412.54 | Professional | 52 · Reduced service | $57.54 | $398.11 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $158.49 Typical High $575.44 | Professional | 53 · Discontinued | $22.91 | $158.49 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $79.43 Typical High $281.84 | Professional | 56 · Pre-op care only | $11.48 | $79.43 | $281.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $177.83 Median $2,187.76 Typical High $2,570.40 | Professional | 63 · Small infant | $177.83 | $2,187.76 | $2,570.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $117.49 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $100.00 | $117.49 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $229.09 Typical High $1,412.54 | Professional | 52 · Reduced service | $57.54 | $229.09 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $91.20 Typical High $575.44 | Professional | 53 · Discontinued | $22.91 | $91.20 | $575.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $93.33 Typical High $281.84 | Professional | 56 · Pre-op care only | $24.55 | $93.33 | $281.84 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $26.30 Typical High $181.97 | Professional | 56 · Pre-op care only | $16.60 | $26.30 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $199.53 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $123.03 | $199.53 | $1,348.96 |
Where Idaho sits
The same service costs 14.1 times more in Washington 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· 21st of 51
$794
WA $1,288KY $91.20
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.