How much rates vary
Facilitymedian $347 · 10th to 90th $120 to $2,089Professionalmedian $219 · 10th to 90th $148 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 $125.89 Median $208.93 Typical High $309.03 | Professional | None | $125.89 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $158.49 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $380.19 Typical High $2,454.71 | Facility | None | $125.89 | $380.19 | $2,454.71 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $380.19 | Professional | None | $186.21 | $275.42 | $380.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $239.88 Typical High $354.81 | Professional | 54 · Surgery only | $173.78 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $162.18 | Facility | None | $107.15 | $120.23 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $275.42 | Professional | None | $169.82 | $204.17 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $5,495.41 | Facility | None | $141.25 | $208.93 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $346.74 | Professional | None | $141.25 | $229.09 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $158.49 | $229.09 |
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 $208.93 Median $208.93 Typical High $346.74 | Facility | None | $208.93 | $208.93 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $371.54 | Professional | None | $208.93 | $346.74 | $371.54 |
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 $186.21 Median $245.47 Typical High $295.12 | Professional | None | $186.21 | $245.47 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $1,000.00 | Facility | None | $165.96 | $169.82 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $223.87 | Professional | None | $134.90 | $165.96 | $223.87 |
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 $134.90 Median $204.17 Typical High $302.00 | Professional | None | $134.90 | $204.17 | $302.00 |
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 $70.79 Median $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $70.79 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $28.18 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $30.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $38.02 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $38.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $234.42 Median $281.84 Typical High $467.74 | Professional | 63 · Small infant | $234.42 | $281.84 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $70.79 | $104.71 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $28.18 | $41.69 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $31.62 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $30.90 |
Where Idaho sits
The same service costs 3.7 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
$229
WI $501KY $135
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.