How much rates vary
Facilitymedian $151 · 10th to 90th $19 to $832Professionalmedian $50 · 10th to 90th $35 to $78
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $77.62 | Professional | None | $30.20 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $22.91 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $4.57 | $9.33 | $11.75 |
BCBS Idaho Setting Facility Modifier None Typical Low $19.50 Median $288.40 Typical High $794.33 | Facility | None | $19.50 | $288.40 | $794.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $70.79 | Professional | None | $38.90 | $57.54 | $70.79 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $42.66 Typical High $66.07 | Professional | 54 · Surgery only | $35.48 | $42.66 | $66.07 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $6.03 Typical High $7.08 | Professional | 55 · Aftercare only | $4.07 | $6.03 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $19.95 Typical High $26.92 | Facility | None | $17.78 | $19.95 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $50.12 | Professional | None | $34.67 | $39.81 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $77.62 Typical High $5,495.41 | Facility | None | $28.84 | $77.62 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $35.48 Median $61.66 Typical High $77.62 | Professional | None | $35.48 | $61.66 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $45.71 Typical High $57.54 | Professional | 54 · Surgery only | $22.91 | $45.71 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $4.57 | $9.33 | $11.75 |
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 $42.66 Median $42.66 Typical High $66.07 | Facility | None | $42.66 | $42.66 | $66.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | None | $42.66 | $61.66 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | 54 · Surgery only | $42.66 | $42.66 | $56.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $977.24 | Facility | None | $524.81 | $758.58 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $77.62 | Professional | None | $48.98 | $60.26 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $575.44 | Facility | None | $30.90 | $31.62 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $40.74 | Professional | None | $18.20 | $30.90 | $40.74 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $27.54 Median $42.66 Typical High $67.61 | Professional | None | $27.54 | $42.66 | $67.61 |
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 $15.14 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $15.14 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $6.03 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.02 | $6.17 | $7.76 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $46.77 Median $69.18 Typical High $85.11 | Professional | 63 · Small infant | $46.77 | $69.18 | $85.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $27.54 Median $33.11 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $27.54 | $33.11 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $30.90 Typical High $38.90 | Professional | 52 · Reduced service | $15.14 | $30.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $6.03 | $12.30 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.02 | $6.17 | $7.76 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.94 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $46.77 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $46.77 | $46.77 | $60.26 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$50.12
AK $100MD $28.84
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.