How much rates vary
Facilitymedian $355 · 10th to 90th $200 to $1,202Professionalmedian $331 · 10th to 90th $191 to $562
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 $158.49 Median $398.11 Typical High $691.83 | Professional | None | $158.49 | $398.11 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $141.25 | $302.00 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $28.18 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $131.83 | $281.84 | $489.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $389.05 Typical High $1,202.26 | Facility | None | $229.09 | $389.05 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $562.34 | Professional | None | $245.47 | $371.54 | $562.34 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $218.78 | $426.58 | $524.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.84 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $28.84 | $54.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $186.21 | $338.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $331.13 | Facility | None | $218.78 | $245.47 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | None | $190.55 | $257.04 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $575.44 Typical High $4,466.84 | Facility | None | $190.55 | $575.44 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $691.83 | Professional | None | $213.80 | $398.11 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $141.25 | $302.00 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $28.18 | $60.26 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $131.83 | $281.84 | $489.78 |
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 $257.04 Median $257.04 Typical High $524.81 | Facility | None | $257.04 | $257.04 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $524.81 | Professional | None | $257.04 | $426.58 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $190.55 | $302.00 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $204.17 | $323.59 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $478.63 | Professional | None | $263.03 | $323.59 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $549.54 | Facility | None | $245.47 | $251.19 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $309.03 | Professional | None | $162.18 | $245.47 | $309.03 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $426.58 | Professional | None | $147.91 | $257.04 | $426.58 |
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 $95.50 Median $199.53 Typical High $346.74 | Professional | 52 · Reduced service | $95.50 | $199.53 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $79.43 Typical High $138.04 | Professional | 53 · Discontinued | $38.02 | $79.43 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $39.81 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.05 | $39.81 | $69.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $316.23 Median $588.84 Typical High $707.95 | Professional | 63 · Small infant | $316.23 | $588.84 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $199.53 Typical High $346.74 | Professional | 52 · Reduced service | $95.50 | $199.53 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $79.43 Typical High $138.04 | Professional | 53 · Discontinued | $38.02 | $79.43 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $39.81 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.05 | $39.81 | $69.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $46.77 |
Where Idaho sits
The same service costs 3.5 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
$331
AK $562DC $162
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.