How much rates vary
Facilitymedian $537 · 10th to 90th $339 to $1,778Professionalmedian $372 · 10th to 90th $219 to $794
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 $208.93 Median $398.11 Typical High $870.96 | Professional | None | $208.93 | $398.11 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $281.84 Typical High $660.69 | Professional | 54 · Surgery only | $158.49 | $281.84 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $831.76 Typical High $1,778.28 | Facility | None | $446.68 | $831.76 | $1,778.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $537.03 Typical High $776.25 | Professional | None | $251.19 | $537.03 | $776.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $489.78 Typical High $691.83 | Professional | 54 · Surgery only | $245.47 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $524.81 | Facility | None | $338.84 | $380.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $630.96 | Professional | None | $229.09 | $346.74 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $562.34 Typical High $5,495.41 | Facility | None | $173.78 | $562.34 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $489.78 Typical High $870.96 | Professional | None | $245.47 | $489.78 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $281.84 Typical High $660.69 | Professional | 54 · Surgery only | $158.49 | $281.84 | $660.69 |
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 $288.40 Median $288.40 Typical High $707.95 | Facility | None | $288.40 | $288.40 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $758.58 | Professional | None | $288.40 | $501.19 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,238.72 | Facility | None | $1,122.02 | $1,584.89 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $660.69 | Professional | None | $251.19 | $331.13 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $1,445.44 | Facility | None | $338.84 | $346.74 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $457.09 | Professional | None | $181.97 | $338.84 | $457.09 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $181.97 Median $389.05 Typical High $707.95 | Professional | None | $181.97 | $389.05 | $707.95 |
11 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 $104.71 Median $186.21 Typical High $436.52 | Professional | 52 · Reduced service | $104.71 | $186.21 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $74.13 Typical High $173.78 | Professional | 53 · Discontinued | $41.69 | $74.13 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $56.23 Typical High $131.83 | Professional | 55 · Aftercare only | $31.62 | $56.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $37.15 Typical High $87.10 | Professional | 56 · Pre-op care only | $20.89 | $37.15 | $87.10 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $77.62 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $77.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $389.05 Typical High $933.25 | Professional | 63 · Small infant | $323.59 | $389.05 | $933.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $218.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $186.21 | $218.78 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $186.21 Typical High $436.52 | Professional | 52 · Reduced service | $104.71 | $186.21 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $74.13 Typical High $173.78 | Professional | 53 · Discontinued | $41.69 | $74.13 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $56.23 Typical High $131.83 | Professional | 55 · Aftercare only | $31.62 | $56.23 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $37.15 Typical High $87.10 | Professional | 56 · Pre-op care only | $20.89 | $37.15 | $87.10 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 18th of 51
$447
WI $871KY $309
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.