How much rates vary
Facilitymedian $562 · 10th to 90th $269 to $2,291Professionalmedian $407 · 10th to 90th $263 to $692
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 $489.78 Median $1,000.00 Typical High $5,495.41 | Facility | None | $489.78 | $1,000.00 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $562.34 Typical High $831.76 | Professional | None | $213.80 | $562.34 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $208.93 | $426.58 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $41.69 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $194.98 | $398.11 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $269.15 Median $691.83 Typical High $2,398.83 | Facility | None | $269.15 | $691.83 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $691.83 | Professional | None | $363.08 | $478.63 | $691.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $616.60 | Professional | 54 · Surgery only | $316.23 | $436.52 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $41.69 Typical High $64.57 | Professional | 55 · Aftercare only | $35.48 | $41.69 | $64.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $263.03 | $416.87 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $398.11 | Facility | None | $263.03 | $295.12 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $457.09 | Professional | None | $269.15 | $323.59 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $758.58 Typical High $2,290.87 | Facility | None | $208.93 | $758.58 | $2,290.87 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $549.54 Typical High $831.76 | Professional | None | $269.15 | $549.54 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $208.93 | $426.58 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $41.69 | $85.11 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $194.98 | $398.11 | $588.84 |
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 $380.19 Median $380.19 Typical High $630.96 | Facility | None | $380.19 | $380.19 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $630.96 | Professional | None | $380.19 | $549.54 | $630.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $263.03 | $389.05 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $416.87 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,318.26 | $2,041.74 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $562.34 | Professional | None | $371.54 | $407.38 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $1,148.15 | Facility | None | $302.00 | $309.03 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $363.08 | Professional | None | $245.47 | $302.00 | $363.08 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $501.19 | Professional | None | $208.93 | $295.12 | $501.19 |
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 $138.04 Median $281.84 Typical High $416.87 | Professional | 52 · Reduced service | $138.04 | $281.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $112.20 Typical High $165.96 | Professional | 53 · Discontinued | $54.95 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $56.23 Typical High $83.18 | Professional | 56 · Pre-op care only | $27.54 | $56.23 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $436.52 Median $660.69 Typical High $851.14 | Professional | 63 · Small infant | $436.52 | $660.69 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $281.84 Typical High $416.87 | Professional | 52 · Reduced service | $138.04 | $281.84 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $112.20 Typical High $165.96 | Professional | 53 · Discontinued | $54.95 | $112.20 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $56.23 Typical High $83.18 | Professional | 56 · Pre-op care only | $27.54 | $56.23 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $54.95 | $54.95 |
Where Idaho sits
The same service costs 3.8 times more in Alaska 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· 9th of 51
$417
AK $776KY $204
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.