How much rates vary
Facilitymedian $186 · 10th to 90th $58 to $741Professionalmedian $120 · 10th to 90th $81 to $195
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 $74.13 Median $117.49 Typical High $199.53 | Professional | None | $74.13 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $151.36 | Professional | 54 · Surgery only | $60.26 | $107.15 | $151.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $58.88 Median $263.03 Typical High $741.31 | Facility | None | $58.88 | $263.03 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $194.98 | Professional | None | $95.50 | $134.90 | $194.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $91.20 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $57.54 Typical High $79.43 | Facility | None | $51.29 | $57.54 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $141.25 | Professional | None | $89.13 | $109.65 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $199.53 Typical High $5,495.41 | Facility | None | $75.86 | $199.53 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $199.53 | Professional | None | $81.28 | $144.54 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $107.15 Typical High $151.36 | Professional | 54 · Surgery only | $60.26 | $107.15 | $151.36 |
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 $109.65 Median $109.65 Typical High $177.83 | Facility | None | $109.65 | $109.65 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $190.55 | Professional | None | $109.65 | $177.83 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $812.83 | Facility | None | $467.74 | $602.56 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $144.54 | Professional | None | $95.50 | $123.03 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $616.60 | Facility | None | $85.11 | $87.10 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $112.20 | Professional | None | $69.18 | $85.11 | $112.20 |
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 $69.18 Median $107.15 Typical High $158.49 | Professional | None | $69.18 | $107.15 | $158.49 |
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 $40.74 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $40.74 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $16.22 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $21.38 Typical High $30.20 | Professional | 55 · Aftercare only | $12.02 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.13 | $14.45 | $19.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $10.23 | $16.60 | $19.95 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $123.03 Median $147.91 Typical High $234.42 | Professional | 63 · Small infant | $123.03 | $147.91 | $234.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $87.10 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $74.13 | $87.10 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $40.74 | $72.44 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $16.22 | $28.84 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $21.38 Typical High $30.20 | Professional | 55 · Aftercare only | $12.02 | $21.38 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.13 | $14.45 | $19.95 |
Where Idaho sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 15th of 51
$123
WI $269FL $75.86
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.