How much rates vary
Facilitymedian $676 · 10th to 90th $447 to $2,754Professionalmedian $1,738 · 10th to 90th $1,072 to $2,188
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,174.90 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $870.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $177.83 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $812.83 | $1,548.82 | $1,548.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $588.84 Median $676.08 Typical High $2,398.83 | Facility | None | $588.84 | $676.08 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,862.09 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,621.81 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $194.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,258.93 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,258.93 | $1,380.38 |
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 $1,000.00 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,258.93 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $5,495.41 | Facility | None | $812.83 | $2,187.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,174.90 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $870.96 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $177.83 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $812.83 | $1,548.82 | $1,548.82 |
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 $1,412.54 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,412.54 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,737.80 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $2,951.21 | Facility | None | $1,584.89 | $2,290.87 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $851.14 Typical High $1,479.11 | Facility | None | $831.76 | $851.14 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,412.54 | Professional | None | $549.54 | $831.76 | $1,412.54 |
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 $851.14 Median $1,258.93 Typical High $1,737.80 | Professional | None | $851.14 | $1,258.93 | $1,737.80 |
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 $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $588.84 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $234.42 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $117.49 | $218.78 | $218.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,949.84 Median $2,187.76 Typical High $2,344.23 | Professional | 63 · Small infant | $1,949.84 | $2,187.76 | $2,344.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $588.84 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $234.42 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $117.49 | $218.78 | $218.78 |
Where Idaho sits
The same service costs 22.4 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· 8th of 51
$1,738
AK $3,981TX $178
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.