How much rates vary
Facilitymedian $550 · 10th to 90th $288 to $1,905Professionalmedian $204 · 10th to 90th $132 to $257
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 $138.04 Median $257.04 Typical High $257.04 | Professional | None | $138.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $38.90 | $38.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $1,819.70 | Facility | None | $524.81 | $676.08 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $239.88 | Professional | None | $186.21 | $218.78 | $239.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $204.17 | Professional | 54 · Surgery only | $165.96 | $190.55 | $204.17 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $645.65 | Facility | None | $426.58 | $478.63 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $186.21 | Professional | None | $134.90 | $162.18 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $257.04 Typical High $5,495.41 | Facility | None | $117.49 | $257.04 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $257.04 | Professional | None | $138.04 | $229.09 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $38.90 | $38.90 |
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 $165.96 Median $204.17 Typical High $204.17 | Facility | None | $165.96 | $204.17 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $354.81 | Professional | None | $204.17 | $204.17 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,230.27 | $1,778.28 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $257.04 | Professional | None | $190.55 | $229.09 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $1,584.89 | Facility | None | $97.72 | $97.72 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | None | $97.72 | $97.72 | $138.04 |
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 $109.65 Median $144.54 Typical High $239.88 | Professional | None | $109.65 | $144.54 | $239.88 |
8 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 $69.18 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $25.70 | $25.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $251.19 Typical High $275.42 | Professional | 63 · Small infant | $218.78 | $251.19 | $275.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $25.70 | $25.70 |
Where Idaho sits
The same service costs 4.4 times more in Alaska than in New York. 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· 14th of 51
$234
AK $513NY $117
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.