How much rates vary
Facilitymedian $407 · 10th to 90th $72 to $2,089Professionalmedian $123 · 10th to 90th $79 to $204
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 $66.07 Median $114.82 Typical High $177.83 | Professional | None | $66.07 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $85.11 Typical High $134.90 | Professional | 54 · Surgery only | $57.54 | $85.11 | $134.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $602.56 Typical High $2,089.30 | Facility | None | $77.62 | $602.56 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | None | $100.00 | $158.49 | $218.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $93.33 | $169.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $72.44 Typical High $100.00 | Facility | None | $64.57 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $158.49 | Professional | None | $91.20 | $114.82 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $162.18 Typical High $5,495.41 | Facility | None | $75.86 | $162.18 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $199.53 | Professional | None | $75.86 | $125.89 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $85.11 Typical High $134.90 | Professional | 54 · Surgery only | $57.54 | $85.11 | $134.90 |
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 $112.20 Median $112.20 Typical High $204.17 | Facility | None | $112.20 | $112.20 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $218.78 | Professional | None | $112.20 | $194.98 | $218.78 |
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 $100.00 Median $131.83 Typical High $169.82 | Professional | None | $100.00 | $131.83 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $1,174.90 | Facility | None | $97.72 | $97.72 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $128.82 | Professional | None | $70.79 | $97.72 | $128.82 |
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 $72.44 Median $114.82 Typical High $169.82 | Professional | None | $72.44 | $114.82 | $169.82 |
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 $38.02 Median $56.23 Typical High $89.13 | Professional | 52 · Reduced service | $38.02 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $22.91 Typical High $36.31 | Professional | 53 · Discontinued | $15.14 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.98 Typical High $26.92 | Professional | 55 · Aftercare only | $11.48 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $17.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $21.88 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $21.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $125.89 Median $151.36 Typical High $257.04 | Professional | 63 · Small infant | $125.89 | $151.36 | $257.04 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $85.11 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $72.44 | $85.11 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $56.23 Typical High $89.13 | Professional | 52 · Reduced service | $38.02 | $56.23 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $22.91 Typical High $36.31 | Professional | 53 · Discontinued | $15.14 | $22.91 | $36.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.98 Typical High $26.92 | Professional | 55 · Aftercare only | $11.48 | $16.98 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $17.78 |
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· 18th of 51
$126
WI $282KY $77.62
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.