How much rates vary
Facilitymedian $891 · 10th to 90th $363 to $3,090Professionalmedian $251 · 10th to 90th $120 to $490
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 $120.23 Median $251.19 Typical High $616.60 | Professional | None | $120.23 | $251.19 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $190.55 Typical High $467.74 | Professional | 54 · Surgery only | $91.20 | $190.55 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $38.02 Typical High $93.33 | Professional | 55 · Aftercare only | $18.20 | $38.02 | $93.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $741.31 Median $1,380.38 Typical High $3,090.30 | Facility | None | $741.31 | $1,380.38 | $3,090.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $489.78 | Professional | None | $154.88 | $309.03 | $489.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $151.36 | $363.08 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $15.14 | $40.74 | $48.98 |
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 $120.23 Median $199.53 Typical High $331.13 | Professional | None | $120.23 | $199.53 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $363.08 Typical High $5,495.41 | Facility | None | $120.23 | $363.08 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $616.60 | Professional | None | $141.25 | $251.19 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $190.55 Typical High $467.74 | Professional | 54 · Surgery only | $91.20 | $190.55 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $38.02 Typical High $93.33 | Professional | 55 · Aftercare only | $18.20 | $38.02 | $93.33 |
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 $162.18 Median $162.18 Typical High $446.68 | Facility | None | $162.18 | $162.18 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $446.68 | Professional | None | $162.18 | $269.15 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $120.23 | $190.55 | $281.84 |
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 $165.96 Median $223.87 Typical High $426.58 | Professional | None | $165.96 | $223.87 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $2,344.23 | Facility | None | $213.80 | $218.78 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $257.04 | Professional | None | $104.71 | $213.80 | $257.04 |
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 $97.72 Median $204.17 Typical High $380.19 | Professional | None | $97.72 | $204.17 | $380.19 |
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 $60.26 Median $125.89 Typical High $309.03 | Professional | 52 · Reduced service | $60.26 | $125.89 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $51.29 Typical High $123.03 | Professional | 53 · Discontinued | $23.99 | $51.29 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $25.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $12.02 | $25.70 | $61.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $199.53 Median $213.80 Typical High $575.44 | Professional | 63 · Small infant | $199.53 | $213.80 | $575.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $123.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $107.15 | $123.03 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $125.89 Typical High $309.03 | Professional | 52 · Reduced service | $60.26 | $125.89 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $51.29 Typical High $123.03 | Professional | 53 · Discontinued | $23.99 | $51.29 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $25.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $12.02 | $25.70 | $61.66 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.92 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.98 | $26.92 | $40.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $302.00 |
Where Idaho sits
The same service costs 4.2 times more in Alaska than in Washington, DC. 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
$251
AK $468DC $112
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.