How much rates vary
Facilitymedian $550 · 10th to 90th $288 to $1,905Professionalmedian $195 · 10th to 90th $123 to $245
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 $109.65 Median $245.47 Typical High $245.47 | Professional | None | $109.65 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $81.28 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $16.22 | $37.15 | $37.15 |
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 $177.83 Median $208.93 Typical High $229.09 | Professional | None | $177.83 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $158.49 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $21.88 |
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 $125.89 Median $151.36 Typical High $173.78 | Professional | None | $125.89 | $151.36 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $245.47 Typical High $5,495.41 | Facility | None | $117.49 | $245.47 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $245.47 | Professional | None | $131.83 | $213.80 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $97.72 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $37.15 | $37.15 |
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 $158.49 Median $194.98 Typical High $194.98 | Facility | None | $158.49 | $194.98 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $338.84 | Professional | None | $194.98 | $194.98 | $338.84 |
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 $181.97 Median $218.78 Typical High $245.47 | Professional | None | $181.97 | $218.78 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $1,584.89 | Facility | None | $93.33 | $93.33 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $131.83 | Professional | None | $93.33 | $93.33 | $131.83 |
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 $95.50 Median $158.49 Typical High $229.09 | Professional | None | $95.50 | $158.49 | $229.09 |
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 $54.95 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $24.55 | $24.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $208.93 Median $239.88 Typical High $263.03 | Professional | 63 · Small infant | $208.93 | $239.88 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $66.07 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $26.30 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.18 | $24.55 | $24.55 |
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
$224
AK $479NY $110
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.