How much rates vary
Facilitymedian $363 · 10th to 90th $112 to $2,089Professionalmedian $269 · 10th to 90th $186 to $363
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 $186.21 Median $281.84 Typical High $346.74 | Professional | None | $186.21 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $213.80 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $114.82 Median $380.19 Typical High $2,089.30 | Facility | None | $114.82 | $380.19 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | None | $213.80 | $275.42 | $389.05 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $245.47 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $151.36 | Facility | None | $100.00 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $275.42 | Professional | None | $194.98 | $234.42 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $281.84 Typical High $5,495.41 | Facility | None | $165.96 | $281.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $346.74 | Professional | None | $199.53 | $281.84 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $213.80 | $263.03 |
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 $251.19 Median $251.19 Typical High $363.08 | Facility | None | $251.19 | $251.19 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $398.11 | Professional | None | $251.19 | $363.08 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,630.27 | Facility | None | $1,230.27 | $1,819.70 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $295.12 | Professional | None | $213.80 | $269.15 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $1,000.00 | Facility | None | $173.78 | $177.83 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | None | $158.49 | $173.78 | $229.09 |
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 $154.88 Median $223.87 Typical High $338.84 | Professional | None | $154.88 | $223.87 | $338.84 |
12 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 $93.33 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $34.67 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $38.90 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $38.90 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | 62 · Two surgeons | $144.54 | $169.82 | $245.47 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $338.84 Typical High $467.74 | Professional | 63 · Small infant | $275.42 | $338.84 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $194.98 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $141.25 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $56.23 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $34.67 |
Where Idaho sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$269
AK $575PA $170
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.