How much rates vary
Facilitymedian $2,138 · 10th to 90th $468 to $7,413Professionalmedian $407 · 10th to 90th $275 to $575
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 $457.09 Median $616.60 Typical High $5,495.41 | Facility | None | $457.09 | $616.60 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $524.81 | Professional | None | $234.42 | $407.38 | $524.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $8,128.31 | Facility | None | $1,737.80 | $2,630.27 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $645.65 | Professional | None | $363.08 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | None | $302.00 | $363.08 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $616.60 Typical High $9,120.11 | Facility | None | $275.42 | $616.60 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $588.84 | Professional | None | $275.42 | $446.68 | $588.84 |
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 $407.38 Median $407.38 Typical High $575.44 | Facility | None | $407.38 | $407.38 | $575.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $676.08 | Professional | None | $407.38 | $575.44 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,244.36 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $489.78 | Professional | None | $363.08 | $446.68 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $3,630.78 | Facility | None | $275.42 | $281.84 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $371.54 | Professional | None | $257.04 | $275.42 | $371.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $501.19 | Professional | None | $234.42 | $346.74 | $501.19 |
16 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 $138.04 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $54.95 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $204.17 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $575.44 | Professional | 54 · Surgery only | $338.84 | $407.38 | $575.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $56.23 | $64.57 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $630.96 Typical High $776.25 | Professional | 63 · Small infant | $446.68 | $630.96 | $776.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $204.17 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $54.95 | $81.28 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $204.17 | $302.00 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $363.08 |
Where Idaho sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $5,029WV $590
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.