How much rates vary
Facilitymedian $347 · 10th to 90th $117 to $1,820Professionalmedian $229 · 10th to 90th $145 to $355
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 $131.83 Median $257.04 Typical High $363.08 | Professional | None | $131.83 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $100.00 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $38.02 Typical High $54.95 | Professional | 55 · Aftercare only | $19.95 | $38.02 | $54.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $1,819.70 | Facility | None | $117.49 | $218.78 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $338.84 | Professional | None | $173.78 | $257.04 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $151.36 | $234.42 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $33.11 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $162.18 | Facility | None | $107.15 | $120.23 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $229.09 | Professional | None | $144.54 | $173.78 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $363.08 Typical High $4,466.84 | Facility | None | $131.83 | $363.08 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $363.08 | Professional | None | $154.88 | $257.04 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $100.00 | $190.55 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $38.02 Typical High $54.95 | Professional | 55 · Aftercare only | $19.95 | $38.02 | $54.95 |
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 $181.97 Median $181.97 Typical High $309.03 | Facility | None | $181.97 | $181.97 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $389.05 | Professional | None | $181.97 | $257.04 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | 54 · Surgery only | $181.97 | $181.97 | $263.03 |
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 $213.80 Median $251.19 Typical High $354.81 | Professional | None | $213.80 | $251.19 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $602.56 | Facility | None | $147.91 | $151.36 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $190.55 | Professional | None | $104.71 | $147.91 | $190.55 |
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 $117.49 Median $165.96 Typical High $257.04 | Professional | None | $117.49 | $165.96 | $257.04 |
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 $66.07 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $66.07 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $26.30 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $13.18 | $25.70 | $36.31 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $204.17 Median $239.88 Typical High $398.11 | Professional | 63 · Small infant | $204.17 | $239.88 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $117.49 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $66.07 | $128.82 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $26.30 | $51.29 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $13.18 | $25.70 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $37.15 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $281.84 |
Where Idaho sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$229
AK $437FL $123
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.