How much rates vary
Facilitymedian $324 · 10th to 90th $115 to $2,089Professionalmedian $240 · 10th to 90th $158 to $372
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 $141.25 Median $275.42 Typical High $380.19 | Professional | None | $141.25 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $107.15 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $21.38 | $40.74 | $56.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $331.13 Typical High $2,089.30 | Facility | None | $117.49 | $331.13 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $354.81 | Professional | None | $181.97 | $281.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $323.59 | Professional | 54 · Surgery only | $162.18 | $190.55 | $323.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $162.18 | Facility | None | $104.71 | $117.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $239.88 | Professional | None | $158.49 | $186.21 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $380.19 Typical High $5,495.41 | Facility | None | $141.25 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $380.19 | Professional | None | $169.82 | $275.42 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $107.15 | $204.17 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $21.38 | $40.74 | $56.23 |
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 $323.59 | Facility | None | $194.98 | $194.98 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $407.38 | Professional | None | $194.98 | $281.84 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $194.98 | $194.98 | $275.42 |
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 $269.15 Typical High $371.54 | Professional | None | $234.42 | $269.15 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | None | $154.88 | $154.88 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Professional | None | $107.15 | $154.88 | $199.53 |
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 $125.89 Median $177.83 Typical High $275.42 | Professional | None | $125.89 | $177.83 | $275.42 |
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 $70.79 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $70.79 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $28.18 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $14.13 | $27.54 | $38.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $354.81 Typical High $426.58 | Professional | 63 · Small infant | $223.87 | $354.81 | $426.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $194.98 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $70.79 | $138.04 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $28.18 | $54.95 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $14.13 | $27.54 | $38.02 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $295.12 |
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
$240
AK $468FL $132
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.