How much rates vary
Facilitymedian $525 · 10th to 90th $331 to $2,188Professionalmedian $407 · 10th to 90th $224 to $759
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 $346.74 Median $616.60 Typical High $5,495.41 | Facility | None | $346.74 | $616.60 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $537.03 Typical High $933.25 | Professional | None | $186.21 | $537.03 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $407.38 Typical High $691.83 | Professional | 54 · Surgery only | $204.17 | $407.38 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $81.28 Typical High $138.04 | Professional | 55 · Aftercare only | $40.74 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $380.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $190.55 | $380.19 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $331.13 Median $933.25 Typical High $2,344.23 | Facility | None | $331.13 | $933.25 | $2,344.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $758.58 | Professional | None | $354.81 | $478.63 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $371.54 Typical High $588.84 | Professional | 54 · Surgery only | $323.59 | $371.54 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $77.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $489.78 | Facility | None | $323.59 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $501.19 | Professional | None | $234.42 | $309.03 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $537.03 Typical High $1,318.26 | Facility | None | $177.83 | $537.03 | $1,318.26 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $537.03 Typical High $933.25 | Professional | None | $223.87 | $537.03 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $407.38 Typical High $691.83 | Professional | 54 · Surgery only | $204.17 | $407.38 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $81.28 Typical High $138.04 | Professional | 55 · Aftercare only | $40.74 | $81.28 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $380.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $190.55 | $380.19 | $645.65 |
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 $691.83 | Facility | None | $380.19 | $380.19 | $691.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $691.83 | Professional | None | $371.54 | $575.44 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $398.11 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $269.15 | $426.58 | $457.09 |
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 $354.81 Median $389.05 Typical High $630.96 | Professional | None | $354.81 | $389.05 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $1,479.11 | Facility | None | $331.13 | $338.84 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $389.05 | Professional | None | $239.88 | $331.13 | $389.05 |
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 $169.82 Median $275.42 Typical High $489.78 | Professional | None | $169.82 | $275.42 | $489.78 |
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 $134.90 Median $269.15 Typical High $467.74 | Professional | 52 · Reduced service | $134.90 | $269.15 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $107.15 Typical High $186.21 | Professional | 53 · Discontinued | $53.70 | $107.15 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $53.70 Typical High $93.33 | Professional | 56 · Pre-op care only | $26.92 | $53.70 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $416.87 Median $489.78 Typical High $831.76 | Professional | 63 · Small infant | $416.87 | $489.78 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $269.15 Typical High $467.74 | Professional | 52 · Reduced service | $134.90 | $269.15 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $107.15 Typical High $186.21 | Professional | 53 · Discontinued | $53.70 | $107.15 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $53.70 Typical High $93.33 | Professional | 56 · Pre-op care only | $26.92 | $53.70 | $93.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $57.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $57.54 | $60.26 |
Where Idaho sits
The same service costs 4.5 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 $741KY $166
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.