How much rates vary
Facilitymedian $2,692 · 10th to 90th $617 to $10,471Professionalmedian $617 · 10th to 90th $302 to $1,778
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $741.31 Typical High $2,511.89 | Professional | None | $281.84 | $741.31 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $467.74 Typical High $1,905.46 | Professional | 54 · Surgery only | $239.88 | $467.74 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $93.33 Typical High $380.19 | Professional | 55 · Aftercare only | $47.86 | $93.33 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,122.02 | $3,235.94 | $10,471.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $1,202.26 Typical High $1,698.24 | Professional | None | $346.74 | $1,202.26 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $575.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $309.03 | $575.44 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $165.96 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $741.31 Typical High $1,380.38 | Professional | None | $295.12 | $741.31 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | None | $933.25 | $933.25 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $5,495.41 | Facility | None | $616.60 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $2,511.89 | Professional | None | $302.00 | $616.60 | $2,511.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,905.46 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $380.19 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $380.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $457.09 | Professional | None | $33.11 | $33.11 | $457.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $1,584.89 | Facility | None | $363.08 | $363.08 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $933.25 Typical High $1,584.89 | Professional | None | $363.08 | $933.25 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $1,659.59 | Professional | None | $389.05 | $524.81 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $3,235.94 | Facility | None | $741.31 | $758.58 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $1,148.15 | Professional | None | $323.59 | $741.31 | $1,148.15 |
United Setting Facility Modifier None Typical Low $9,549.93 Median $16,982.44 Typical High $18,197.01 | Facility | None | $9,549.93 | $16,982.44 | $18,197.01 |
United Setting Professional Modifier None Typical Low $234.42 Median $691.83 Typical High $1,479.11 | Professional | None | $234.42 | $691.83 | $1,479.11 |
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 $158.49 Median $309.03 Typical High $1,258.93 | Professional | 52 · Reduced service | $158.49 | $309.03 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $123.03 Typical High $501.19 | Professional | 53 · Discontinued | $63.10 | $123.03 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $61.66 Typical High $251.19 | Professional | 56 · Pre-op care only | $31.62 | $61.66 | $251.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $416.87 Median $1,737.80 Typical High $2,041.74 | Professional | 63 · Small infant | $416.87 | $1,737.80 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $1,258.93 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $501.19 | Professional | 53 · Discontinued | $123.03 | $123.03 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $251.19 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $251.19 |
Where Idaho sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 14th of 51
$871
WI $1,514MD $282
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.