How much rates vary
Facilitymedian $363 · 10th to 90th $141 to $2,089Professionalmedian $251 · 10th to 90th $158 to $417
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 $144.54 Median $281.84 Typical High $426.58 | Professional | None | $144.54 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $208.93 Typical High $323.59 | Professional | 54 · Surgery only | $109.65 | $208.93 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $41.69 Typical High $64.57 | Professional | 55 · Aftercare only | $21.88 | $41.69 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $2,089.30 | Facility | None | $141.25 | $239.88 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $398.11 | Professional | None | $181.97 | $281.84 | $398.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $371.54 | Professional | 54 · Surgery only | $162.18 | $194.98 | $371.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.88 Typical High $39.81 | Professional | 55 · Aftercare only | $18.20 | $21.88 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $199.53 | Facility | None | $128.82 | $147.91 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | None | $158.49 | $190.55 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $426.58 Typical High $5,495.41 | Facility | None | $144.54 | $426.58 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $426.58 | Professional | None | $169.82 | $281.84 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $208.93 Typical High $323.59 | Professional | 54 · Surgery only | $109.65 | $208.93 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $41.69 Typical High $64.57 | Professional | 55 · Aftercare only | $21.88 | $41.69 | $64.57 |
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 $194.98 Median $194.98 Typical High $363.08 | Facility | None | $194.98 | $194.98 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $457.09 | Professional | None | $194.98 | $281.84 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $194.98 | $302.00 |
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 $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $602.56 | Facility | None | $173.78 | $177.83 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $223.87 | Professional | None | $114.82 | $173.78 | $223.87 |
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 $128.82 Median $186.21 Typical High $288.40 | Professional | None | $128.82 | $186.21 | $288.40 |
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 $72.44 Median $141.25 Typical High $213.80 | Professional | 52 · Reduced service | $72.44 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $56.23 Typical High $85.11 | Professional | 53 · Discontinued | $28.84 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $28.18 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $28.18 | $42.66 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $218.78 Median $263.03 Typical High $478.63 | Professional | 63 · Small infant | $218.78 | $263.03 | $478.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $141.25 Typical High $213.80 | Professional | 52 · Reduced service | $72.44 | $141.25 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $56.23 Typical High $85.11 | Professional | 53 · Discontinued | $28.84 | $56.23 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $28.18 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $28.18 | $42.66 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $323.59 |
Where Idaho sits
The same service costs 3.3 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· 10th of 51
$257
AK $468VA $141
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.