How much rates vary
Facilitymedian $363 · 10th to 90th $141 to $708Professionalmedian $178 · 10th to 90th $115 to $295
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 $100.00 Median $295.12 Typical High $295.12 | Professional | None | $100.00 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $89.13 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $17.78 | $44.67 | $44.67 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $588.84 | Facility | None | $199.53 | $398.11 | $588.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $204.17 | Professional | None | $162.18 | $190.55 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $165.96 | $173.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $169.82 | Professional | None | $125.89 | $144.54 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $295.12 Typical High $5,495.41 | Facility | None | $120.23 | $295.12 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $295.12 | Professional | None | $138.04 | $190.55 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $102.33 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $44.67 | $44.67 |
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 $141.25 Median $173.78 Typical High $173.78 | Facility | None | $141.25 | $173.78 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | None | $173.78 | $173.78 | $194.98 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $134.90 | $134.90 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | None | $173.78 | $204.17 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $575.44 | Facility | None | $83.18 | $85.11 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $186.21 | Professional | None | $83.18 | $83.18 | $186.21 |
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 $109.65 Median $144.54 Typical High $218.78 | Professional | None | $109.65 | $144.54 | $218.78 |
14 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 $58.88 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $58.88 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $23.44 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.75 | $29.51 | $29.51 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $100.00 Median $114.82 Typical High $123.03 | Professional | 62 · Two surgeons | $100.00 | $114.82 | $123.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 63 · Small infant | $194.98 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $69.18 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $27.54 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.80 | $29.51 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 22 · Increased work | $213.80 | $213.80 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 62 · Two surgeons | $123.03 | $123.03 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 63 · Small infant | $213.80 | $213.80 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $144.54 |
Where Idaho sits
The same service costs 13.9 times more in Utah than in Delaware. 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.
Physician feeFacility fee
UT $3,071DE $220
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.