How much rates vary
Facilitymedian $209 · 10th to 90th $37 to $417Professionalmedian $38 · 10th to 90th $30 to $55
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $61.66 | Professional | None | $28.18 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $31.62 Typical High $35.48 | Professional | 54 · Surgery only | $25.12 | $31.62 | $35.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $56.23 Median $204.17 Typical High $389.05 | Facility | None | $56.23 | $204.17 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $46.77 | Professional | None | $34.67 | $40.74 | $46.77 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $35.48 Typical High $50.12 | Professional | 54 · Surgery only | $30.90 | $35.48 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $41.69 | Professional | None | $29.51 | $33.88 | $41.69 |
Moda Health Setting Facility Modifier None Typical Low $18.20 Median $47.86 Typical High $4,466.84 | Facility | None | $18.20 | $47.86 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $48.98 | Professional | None | $24.55 | $37.15 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $31.62 Typical High $35.48 | Professional | 54 · Surgery only | $25.12 | $31.62 | $35.48 |
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 $30.90 Median $37.15 Typical High $38.02 | Facility | None | $30.90 | $37.15 | $38.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $54.95 | Professional | None | $32.36 | $37.15 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | 54 · Surgery only | $33.11 | $33.11 | $38.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $416.87 | Facility | None | $218.78 | $309.03 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $43.65 | Professional | None | $32.36 | $37.15 | $43.65 |
Select Health Setting Facility Modifier None Typical Low $17.78 Median $18.20 Typical High $251.19 | Facility | None | $17.78 | $18.20 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $40.74 | Professional | None | $17.78 | $17.78 | $40.74 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $91.20 | Professional | None | $28.18 | $52.48 | $91.20 |
16 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 $16.98 Median $20.89 Typical High $23.99 | Professional | 52 · Reduced service | $16.98 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.32 Typical High $9.55 | Professional | 53 · Discontinued | $6.76 | $8.32 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.31 Typical High $7.08 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.17 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.39 | $4.17 | $4.79 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $63.10 Median $204.17 Typical High $407.38 | Facility | 50 · Both sides | $63.10 | $204.17 | $407.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $60.26 Typical High $83.18 | Professional | 50 · Both sides | $51.29 | $60.26 | $83.18 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.07 Typical High $4.68 | Professional | 55 · Aftercare only | $3.39 | $4.07 | $4.68 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $40.74 Median $47.86 Typical High $56.23 | Professional | 63 · Small infant | $40.74 | $47.86 | $56.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $23.44 Median $28.18 Typical High $38.90 | Professional | 78 · Unplanned return to OR | $23.44 | $28.18 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $20.89 Typical High $23.99 | Professional | 52 · Reduced service | $16.98 | $20.89 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.32 Typical High $9.55 | Professional | 53 · Discontinued | $6.76 | $8.32 | $9.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.31 Typical High $7.08 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $7.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.17 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.39 | $4.17 | $4.79 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 50 · Both sides | $70.79 | $70.79 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $35.48 | $35.48 | $41.69 |
Where Idaho sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 33rd of 51
$39.81
WY $89.13NY $20.89
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.