How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,622 to $8,318Professionalmedian $1,905 · 10th to 90th $1,122 to $2,399
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,047.13 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $954.99 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $891.25 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,884.03 Median $4,897.79 Typical High $9,772.37 | Facility | None | $2,884.03 | $4,897.79 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,089.30 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,380.38 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,445.44 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $2,398.83 Typical High $5,495.41 | Facility | None | $831.76 | $2,398.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,288.25 | $2,089.30 | $2,398.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $954.99 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $891.25 | $1,659.59 | $1,659.59 |
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 $1,548.82 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,548.82 | $1,905.46 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,905.46 | $1,905.46 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $10,471.29 | Facility | None | $5,248.07 | $8,128.31 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,089.30 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $4,677.35 | Facility | None | $912.01 | $933.25 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,137.96 | Professional | None | $933.25 | $1,348.96 | $2,137.96 |
10 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 $645.65 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $645.65 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $257.04 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $190.55 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $128.82 | $239.88 | $239.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $213.80 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,041.74 Median $2,344.23 Typical High $2,570.40 | Professional | 63 · Small infant | $2,041.74 | $2,344.23 | $2,570.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $645.65 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $257.04 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $190.55 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $128.82 | $239.88 | $239.88 |
Where Idaho sits
The same service costs 6.6 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· 10th of 51
$2,042
AK $4,266TX $646
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.