How much rates vary
Facilitymedian $324 · 10th to 90th $58 to $1,820Professionalmedian $105 · 10th to 90th $65 to $195
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 $57.54 Median $104.71 Typical High $194.98 | Professional | None | $57.54 | $104.71 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $79.43 Typical High $147.91 | Professional | 54 · Surgery only | $40.74 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $15.85 Typical High $29.51 | Professional | 55 · Aftercare only | $8.13 | $15.85 | $29.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $436.52 Typical High $1,819.70 | Facility | None | $67.61 | $436.52 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $162.18 | Professional | None | $69.18 | $109.65 | $162.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $72.44 Typical High $134.90 | Professional | 54 · Surgery only | $61.66 | $72.44 | $134.90 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $6.92 | $15.14 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $57.54 Typical High $77.62 | Facility | None | $51.29 | $57.54 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $123.03 | Professional | None | $60.26 | $89.13 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $151.36 Typical High $4,466.84 | Facility | None | $69.18 | $151.36 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $194.98 | Professional | None | $64.57 | $104.71 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $79.43 Typical High $147.91 | Professional | 54 · Surgery only | $43.65 | $79.43 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $15.85 Typical High $29.51 | Professional | 55 · Aftercare only | $8.71 | $15.85 | $29.51 |
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 $74.13 Median $74.13 Typical High $144.54 | Facility | None | $74.13 | $74.13 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $181.97 | Professional | None | $74.13 | $107.15 | $181.97 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | 54 · Surgery only | $75.86 | $75.86 | $138.04 |
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 $87.10 Median $112.20 Typical High $194.98 | Professional | None | $87.10 | $112.20 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $794.33 | Facility | None | $69.18 | $70.79 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $100.00 | Professional | None | $43.65 | $66.07 | $100.00 |
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 $53.70 Median $109.65 Typical High $218.78 | Professional | None | $53.70 | $109.65 | $218.78 |
13 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 $26.92 Median $52.48 Typical High $97.72 | Professional | 52 · Reduced service | $26.92 | $52.48 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $20.89 Typical High $39.81 | Professional | 53 · Discontinued | $10.72 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.47 Typical High $19.50 | Professional | 56 · Pre-op care only | $5.37 | $10.47 | $19.50 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $102.33 Median $575.44 Typical High $2,754.23 | Facility | 50 · Both sides | $102.33 | $575.44 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $125.89 Typical High $234.42 | Professional | 50 · Both sides | $104.71 | $125.89 | $234.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $83.18 Median $128.82 Typical High $190.55 | Professional | 63 · Small infant | $83.18 | $128.82 | $190.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $87.10 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $50.12 | $87.10 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $52.48 Typical High $97.72 | Professional | 52 · Reduced service | $28.84 | $52.48 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $20.89 Typical High $39.81 | Professional | 53 · Discontinued | $11.75 | $20.89 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.47 Typical High $19.50 | Professional | 56 · Pre-op care only | $5.75 | $10.47 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $162.18 Typical High $295.12 | Professional | 50 · Both sides | $162.18 | $162.18 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $81.28 | $147.91 |
Where Idaho sits
The same service costs 3.2 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· 18th of 51
$105
AK $191VA $60.26
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.