How much rates vary
Facilitymedian $245 · 10th to 90th $93 to $832Professionalmedian $162 · 10th to 90th $105 to $263
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 $154.88 Typical High $229.09 | Professional | None | $91.20 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $77.62 | $114.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $831.76 | Facility | None | $97.72 | $295.12 | $831.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $288.40 | Professional | None | $138.04 | $204.17 | $288.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $269.15 | Professional | 54 · Surgery only | $125.89 | $151.36 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $93.33 Typical High $125.89 | Facility | None | $83.18 | $93.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $204.17 | Professional | None | $125.89 | $154.88 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $218.78 Typical High $5,495.41 | Facility | None | $104.71 | $218.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $257.04 | Professional | None | $104.71 | $158.49 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $77.62 | $114.82 | $169.82 |
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 $154.88 Median $154.88 Typical High $263.03 | Facility | None | $154.88 | $154.88 | $263.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $281.84 | Professional | None | $154.88 | $263.03 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $776.25 Typical High $1,047.13 | Facility | None | $549.54 | $776.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $218.78 | Professional | None | $138.04 | $181.97 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $549.54 | Facility | None | $125.89 | $128.82 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $169.82 | Professional | None | $100.00 | $125.89 | $169.82 |
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 $100.00 Median $151.36 Typical High $223.87 | Professional | None | $100.00 | $151.36 | $223.87 |
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 $52.48 Median $77.62 Typical High $114.82 | Professional | 52 · Reduced service | $52.48 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $20.89 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $15.49 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $22.91 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $28.84 | Professional | 55 · Aftercare only | $14.45 | $17.38 | $28.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $208.93 Typical High $331.13 | Professional | 63 · Small infant | $173.78 | $208.93 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $112.20 | $177.83 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $77.62 Typical High $114.82 | Professional | 52 · Reduced service | $52.48 | $77.62 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $20.89 | $30.90 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $15.49 | $23.44 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $22.91 |
Where Idaho sits
The same service costs 3.3 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 $372KY $112
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.