How much rates vary
Facilitymedian $229 · 10th to 90th $132 to $741Professionalmedian $162 · 10th to 90th $95 to $355
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 $91.20 Median $162.18 Typical High $371.54 | Professional | None | $91.20 | $162.18 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $123.03 Typical High $281.84 | Professional | 54 · Surgery only | $67.61 | $123.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $24.55 Typical High $56.23 | Professional | 55 · Aftercare only | $13.49 | $24.55 | $56.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $138.04 Median $263.03 Typical High $741.31 | Facility | None | $138.04 | $263.03 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $354.81 | Professional | None | $109.65 | $245.47 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $316.23 | Professional | 54 · Surgery only | $107.15 | $125.89 | $316.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $35.48 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $194.98 | Facility | None | $128.82 | $144.54 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $245.47 | Professional | None | $100.00 | $144.54 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $234.42 Typical High $5,495.41 | Facility | None | $83.18 | $234.42 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $371.54 | Professional | None | $104.71 | $208.93 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $123.03 Typical High $281.84 | Professional | 54 · Surgery only | $67.61 | $123.03 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $24.55 Typical High $56.23 | Professional | 55 · Aftercare only | $13.49 | $24.55 | $56.23 |
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 $125.89 Median $125.89 Typical High $323.59 | Facility | None | $125.89 | $125.89 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $346.74 | Professional | None | $125.89 | $218.78 | $346.74 |
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 $109.65 Median $141.25 Typical High $269.15 | Professional | None | $109.65 | $141.25 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $562.34 | Facility | None | $154.88 | $158.49 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $204.17 | Professional | None | $79.43 | $154.88 | $204.17 |
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 $79.43 Median $144.54 Typical High $245.47 | Professional | None | $79.43 | $144.54 | $245.47 |
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 $45.71 Median $81.28 Typical High $186.21 | Professional | 52 · Reduced service | $45.71 | $81.28 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $32.36 Typical High $74.13 | Professional | 53 · Discontinued | $18.20 | $32.36 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $16.22 Typical High $37.15 | Professional | 56 · Pre-op care only | $9.12 | $16.22 | $37.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $154.88 Median $363.08 Typical High $436.52 | Professional | 63 · Small infant | $154.88 | $363.08 | $436.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $112.20 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $81.28 | $112.20 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $81.28 Typical High $186.21 | Professional | 52 · Reduced service | $45.71 | $81.28 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $32.36 Typical High $74.13 | Professional | 53 · Discontinued | $18.20 | $32.36 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $16.22 Typical High $37.15 | Professional | 56 · Pre-op care only | $9.12 | $16.22 | $37.15 |
Where Idaho sits
The same service costs 3.6 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· 19th of 51
$162
WI $380KY $105
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.