How much rates vary
Facilitymedian $398 · 10th to 90th $79 to $708Professionalmedian $132 · 10th to 90th $56 to $447
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 $70.79 Median $398.11 Typical High $5,495.41 | Facility | None | $70.79 | $398.11 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $190.55 Typical High $489.78 | Professional | None | $51.29 | $190.55 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $74.13 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $74.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $123.03 Median $457.09 Typical High $691.83 | Facility | None | $123.03 | $457.09 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $66.07 Median $275.42 Typical High $436.52 | Professional | None | $66.07 | $275.42 | $436.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $43.65 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $186.21 Typical High $338.84 | Professional | None | $61.66 | $186.21 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $407.38 Typical High $794.33 | Facility | None | $100.00 | $407.38 | $794.33 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $186.21 Typical High $489.78 | Professional | None | $56.23 | $186.21 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $74.13 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $74.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $114.82 | Professional | None | $33.11 | $33.11 | $114.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $398.11 | Facility | None | $74.13 | $74.13 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $407.38 | Professional | None | $74.13 | $131.83 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $398.11 | Professional | None | $66.07 | $109.65 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $194.98 | Facility | None | $102.33 | $190.55 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $190.55 Typical High $295.12 | Professional | None | $66.07 | $190.55 | $295.12 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $48.98 Median $169.82 Typical High $354.81 | Professional | None | $48.98 | $169.82 | $354.81 |
9 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 $31.62 Median $50.12 Typical High $245.47 | Professional | 52 · Reduced service | $31.62 | $50.12 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.95 Typical High $97.72 | Professional | 53 · Discontinued | $12.59 | $19.95 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.00 Typical High $48.98 | Professional | 56 · Pre-op care only | $6.31 | $10.00 | $48.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $74.13 Typical High $407.38 | Professional | 54 · Surgery only | $61.66 | $74.13 | $407.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $81.28 Median $100.00 Typical High $524.81 | Professional | 63 · Small infant | $81.28 | $100.00 | $524.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $251.19 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $47.86 | $251.19 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $245.47 | Professional | 52 · Reduced service | $50.12 | $50.12 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $97.72 | Professional | 53 · Discontinued | $19.95 | $19.95 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $48.98 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $48.98 |
Where Idaho sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 19th of 51
$191
NC $309HI $58.88
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.