How much rates vary
Facilitymedian $9,550 · 10th to 90th $2,399 to $20,893Professionalmedian $1,318 · 10th to 90th $631 to $12,589
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 $4,466.84 Median $4,786.30 Typical High $7,762.47 | Facility | None | $4,466.84 | $4,786.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $4,786.30 Typical High $17,782.79 | Professional | None | $602.56 | $4,786.30 | $17,782.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $4,073.80 Typical High $13,489.63 | Professional | 54 · Surgery only | $446.68 | $4,073.80 | $13,489.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $812.83 Typical High $2,691.53 | Professional | 55 · Aftercare only | $89.13 | $812.83 | $2,691.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $3,801.89 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $416.87 | $3,801.89 | $12,589.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,623.41 Median $10,000.00 Typical High $30,902.95 | Facility | None | $5,623.41 | $10,000.00 | $30,902.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $758.58 Median $7,762.47 Typical High $12,302.69 | Professional | None | $758.58 | $7,762.47 | $12,302.69 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,230.27 Typical High $10,964.78 | Professional | 54 · Surgery only | $660.69 | $1,230.27 | $10,964.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $1,174.90 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $9,549.93 Typical High $12,882.50 | Facility | None | $8,511.38 | $9,549.93 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $10,232.93 | Professional | None | $630.96 | $1,071.52 | $10,232.93 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $17,782.79 | Facility | None | $602.56 | $4,786.30 | $17,782.79 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $4,466.84 Typical High $17,782.79 | Professional | None | $660.69 | $4,466.84 | $17,782.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $1,862.09 Typical High $13,489.63 | Professional | 54 · Surgery only | $446.68 | $1,862.09 | $13,489.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $371.54 Typical High $2,691.53 | Professional | 55 · Aftercare only | $89.13 | $371.54 | $2,691.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $1,737.80 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $416.87 | $1,737.80 | $12,589.25 |
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 $794.33 Median $794.33 Typical High $11,220.18 | Facility | None | $794.33 | $794.33 | $11,220.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $2,238.72 Typical High $11,220.18 | Professional | None | $794.33 | $2,238.72 | $11,220.18 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $977.24 Typical High $7,762.47 | Professional | 54 · Surgery only | $602.56 | $977.24 | $7,762.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,047.13 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $645.65 | $1,047.13 | $8,317.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,715.19 Median $19,498.45 Typical High $33,884.42 | Facility | None | $10,715.19 | $19,498.45 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $11,481.54 | Professional | None | $870.96 | $1,096.48 | $11,481.54 |
Select Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,495.41 | Facility | None | $5,370.32 | $5,370.32 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $5,370.32 Typical High $7,079.46 | Professional | None | $501.19 | $5,370.32 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $501.19 Median $5,011.87 Typical High $12,589.25 | Professional | None | $501.19 | $5,011.87 | $12,589.25 |
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 $302.00 Median $2,691.53 Typical High $8,912.51 | Professional | 52 · Reduced service | $302.00 | $2,691.53 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $1,071.52 Typical High $3,548.13 | Professional | 53 · Discontinued | $120.23 | $1,071.52 | $3,548.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $537.03 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $60.26 | $537.03 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $912.01 Median $1,071.52 Typical High $14,454.40 | Professional | 63 · Small infant | $912.01 | $1,071.52 | $14,454.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $1,230.27 Typical High $8,912.51 | Professional | 52 · Reduced service | $302.00 | $1,230.27 | $8,912.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $489.78 Typical High $3,548.13 | Professional | 53 · Discontinued | $120.23 | $489.78 | $3,548.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $245.47 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $60.26 | $245.47 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $138.04 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $87.10 | $138.04 | $1,122.02 |
Where Idaho sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.