How much rates vary
Facilitymedian $2,951 · 10th to 90th $832 to $12,303Professionalmedian $776 · 10th to 90th $550 to $955
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | None | $549.54 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $81.28 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $12,882.50 | Facility | None | $2,754.23 | $3,162.28 | $12,882.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $954.99 | Professional | None | $758.58 | $812.83 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $691.83 | $794.33 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $95.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,801.89 | Facility | None | $2,511.89 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $831.76 | Professional | None | $562.34 | $707.95 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $870.96 Typical High $5,495.41 | Facility | None | $489.78 | $870.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $977.24 | Professional | None | $575.44 | $831.76 | $977.24 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $87.10 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $602.56 |
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 $676.08 Median $831.76 Typical High $831.76 | Facility | None | $676.08 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,218.10 | Facility | None | $8,511.38 | $12,302.69 | $16,218.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | None | $758.58 | $758.58 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $5,128.61 | Facility | None | $398.11 | $407.38 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $645.65 | Professional | None | $398.11 | $398.11 | $645.65 |
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 $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $933.25 |
7 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 $275.42 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $275.42 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $109.65 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $54.95 | $87.10 | $87.10 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,071.52 Typical High $1,148.15 | Professional | 63 · Small infant | $933.25 | $1,071.52 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $87.10 |
Where Idaho sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 12th of 51
$832
AK $1,995TX $309
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.