How much rates vary
Facilitymedian $676 · 10th to 90th $347 to $2,399Professionalmedian $363 · 10th to 90th $224 to $589
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 $199.53 Median $389.05 Typical High $588.84 | Professional | None | $199.53 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $295.12 Typical High $436.52 | Professional | 54 · Surgery only | $151.36 | $295.12 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $58.88 Typical High $87.10 | Professional | 55 · Aftercare only | $30.20 | $58.88 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $275.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $141.25 | $275.42 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $416.87 Median $891.25 Typical High $2,398.83 | Facility | None | $416.87 | $891.25 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $524.81 | Professional | None | $257.04 | $389.05 | $524.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $269.15 Typical High $467.74 | Professional | 54 · Surgery only | $223.87 | $269.15 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $52.48 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $52.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $173.78 | $309.03 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $812.83 | Facility | None | $537.03 | $602.56 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | None | $223.87 | $275.42 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $389.05 Typical High $5,495.41 | Facility | None | $162.18 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $588.84 | Professional | None | $223.87 | $389.05 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $295.12 Typical High $436.52 | Professional | 54 · Surgery only | $151.36 | $295.12 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $58.88 Typical High $87.10 | Professional | 55 · Aftercare only | $30.20 | $58.88 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $275.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $141.25 | $275.42 | $407.38 |
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 $269.15 Median $269.15 Typical High $489.78 | Facility | None | $269.15 | $269.15 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $616.60 | Professional | None | $269.15 | $389.05 | $616.60 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $275.42 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $2,951.21 | Facility | None | $1,584.89 | $2,344.23 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $588.84 | Professional | None | $309.03 | $389.05 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $2,041.74 | Facility | None | $234.42 | $234.42 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $549.54 | Professional | None | $158.49 | $234.42 | $549.54 |
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 $173.78 Median $269.15 Typical High $467.74 | Professional | None | $173.78 | $269.15 | $467.74 |
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 $100.00 Median $194.98 Typical High $295.12 | Professional | 52 · Reduced service | $100.00 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $77.62 Typical High $117.49 | Professional | 53 · Discontinued | $39.81 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $38.90 Typical High $58.88 | Professional | 56 · Pre-op care only | $19.95 | $38.90 | $58.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $302.00 Median $467.74 Typical High $616.60 | Professional | 63 · Small infant | $302.00 | $467.74 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $194.98 Typical High $295.12 | Professional | 52 · Reduced service | $100.00 | $194.98 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $77.62 Typical High $117.49 | Professional | 53 · Discontinued | $39.81 | $77.62 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $38.90 Typical High $58.88 | Professional | 56 · Pre-op care only | $19.95 | $38.90 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $60.26 |
Where Idaho sits
The same service costs 4.2 times more in Alaska than in 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.
Idaho· 6th of 51
$389
AK $776VA $186
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.