How much rates vary
Facilitymedian $692 · 10th to 90th $437 to $1,950Professionalmedian $631 · 10th to 90th $407 to $813
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 $588.84 Median $812.83 Typical High $812.83 | Professional | None | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $398.11 | $575.44 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,348.96 | Facility | None | $977.24 | $1,047.13 | $1,348.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $933.25 | Professional | None | $588.84 | $707.95 | $933.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $851.14 | Professional | 54 · Surgery only | $512.86 | $602.56 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $602.56 | Professional | None | $302.00 | $524.81 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $5,495.41 | Facility | None | $436.52 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $812.83 | Professional | None | $524.81 | $630.96 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $436.52 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $407.38 | $575.44 | $575.44 |
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 $512.86 Median $630.96 Typical High $630.96 | Facility | None | $512.86 | $630.96 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $933.25 | Professional | None | $549.54 | $630.96 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | None | $630.96 | $758.58 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $309.03 | Facility | None | $302.00 | $302.00 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $676.08 | Professional | None | $302.00 | $302.00 | $676.08 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $724.44 | Professional | None | $389.05 | $524.81 | $724.44 |
12 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 $288.40 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $288.40 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $57.54 | $81.28 | $81.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $93.33 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $93.33 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $426.58 Typical High $588.84 | Professional | 62 · Two surgeons | $354.81 | $426.58 | $588.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Professional | 63 · Small infant | $691.83 | $812.83 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $87.10 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $81.28 | $81.28 |
Where Idaho sits
The same service costs 6.9 times more in Alaska than in Utah. 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· 13th of 51
$631
AK $1,514UT $219
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.