How much rates vary
Facilitymedian $204 · 10th to 90th $72 to $417Professionalmedian $91 · 10th to 90th $54 to $162
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $165.96 | Professional | None | $51.29 | $91.20 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $67.61 Typical High $125.89 | Professional | 54 · Surgery only | $38.90 | $67.61 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.49 Typical High $25.12 | Professional | 55 · Aftercare only | $7.76 | $13.49 | $25.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $204.17 Typical High $389.05 | Facility | None | $75.86 | $204.17 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $162.18 | Professional | None | $61.66 | $114.82 | $162.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $72.44 Typical High $147.91 | Professional | 54 · Surgery only | $58.88 | $72.44 | $147.91 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.94 Typical High $16.22 | Professional | 55 · Aftercare only | $6.61 | $7.94 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $117.49 | Professional | None | $56.23 | $81.28 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $100.00 Typical High $4,466.84 | Facility | None | $45.71 | $100.00 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $165.96 | Professional | None | $52.48 | $91.20 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $67.61 Typical High $125.89 | Professional | 54 · Surgery only | $38.90 | $67.61 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.49 Typical High $25.12 | Professional | 55 · Aftercare only | $7.76 | $13.49 | $25.12 |
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 $70.79 Median $70.79 Typical High $151.36 | Facility | None | $70.79 | $70.79 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $162.18 | Professional | None | $70.79 | $123.03 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $416.87 | Facility | None | $218.78 | $309.03 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $123.03 | Professional | None | $61.66 | $81.28 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $251.19 | Facility | None | $72.44 | $74.13 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $95.50 | Professional | None | $44.67 | $72.44 | $95.50 |
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 $44.67 Median $75.86 Typical High $131.83 | Professional | None | $44.67 | $75.86 | $131.83 |
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 $25.70 Median $45.71 Typical High $83.18 | Professional | 52 · Reduced service | $25.70 | $45.71 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $18.20 Typical High $33.11 | Professional | 53 · Discontinued | $10.23 | $18.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.12 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.13 | $9.12 | $16.60 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $79.43 Median $162.18 Typical High $204.17 | Professional | 63 · Small infant | $79.43 | $162.18 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $63.10 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $45.71 | $63.10 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $45.71 Typical High $83.18 | Professional | 52 · Reduced service | $25.70 | $45.71 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $18.20 Typical High $33.11 | Professional | 53 · Discontinued | $10.23 | $18.20 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.12 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.13 | $9.12 | $16.60 |
Where Idaho sits
The same service costs 3.4 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· 11th of 51
$100
WI $209KY $61.66
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.