How much rates vary
Facilitymedian $263 · 10th to 90th $98 to $851Professionalmedian $182 · 10th to 90th $120 to $295
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 $104.71 Median $173.78 Typical High $263.03 | Professional | None | $104.71 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $131.83 | $199.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $380.19 Typical High $831.76 | Facility | None | $109.65 | $380.19 | $831.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $316.23 | Professional | None | $154.88 | $234.42 | $316.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $97.72 Typical High $134.90 | Facility | None | $87.10 | $97.72 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $234.42 | Professional | None | $141.25 | $173.78 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $251.19 Typical High $5,495.41 | Facility | None | $117.49 | $251.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $302.00 | Professional | None | $117.49 | $194.98 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $131.83 | $199.53 |
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 $169.82 Median $169.82 Typical High $288.40 | Facility | None | $169.82 | $169.82 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $309.03 | Professional | None | $169.82 | $288.40 | $309.03 |
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 $154.88 Median $204.17 Typical High $251.19 | Professional | None | $154.88 | $204.17 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $575.44 | Facility | None | $138.04 | $141.25 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $190.55 | Professional | None | $109.65 | $138.04 | $190.55 |
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 $112.20 Median $173.78 Typical High $251.19 | Professional | None | $112.20 | $173.78 | $251.19 |
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 $58.88 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $58.88 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $23.44 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $26.30 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $31.62 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $31.62 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $229.09 Typical High $371.54 | Professional | 63 · Small infant | $190.55 | $229.09 | $371.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $58.88 | $87.10 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $23.44 | $34.67 | $52.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $26.30 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $26.30 |
Where Idaho sits
The same service costs 3.2 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
$186
WI $417KY $129
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.