How much rates vary
Facilitymedian $363 · 10th to 90th $182 to $1,660Professionalmedian $263 · 10th to 90th $182 to $407
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 $144.54 Median $239.88 Typical High $380.19 | Professional | None | $144.54 | $239.88 | $380.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $213.80 Median $977.24 Typical High $1,659.59 | Facility | None | $213.80 | $977.24 | $1,659.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $457.09 | Professional | None | $213.80 | $331.13 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $275.42 | Facility | None | $177.83 | $199.53 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $338.84 | Professional | None | $186.21 | $239.88 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $346.74 Typical High $5,495.41 | Facility | None | $147.91 | $346.74 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $380.19 | Professional | None | $190.55 | $251.19 | $380.19 |
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 $229.09 Median $229.09 Typical High $389.05 | Facility | None | $229.09 | $229.09 | $389.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $446.68 | Professional | None | $213.80 | $363.08 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,819.70 | Facility | None | $870.96 | $1,288.25 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $354.81 | Professional | None | $213.80 | $275.42 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $1,202.26 | Facility | None | $199.53 | $204.17 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $269.15 | Professional | None | $154.88 | $199.53 | $269.15 |
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 $144.54 Median $239.88 Typical High $407.38 | Professional | None | $144.54 | $239.88 | $407.38 |
18 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 $91.20 Median $120.23 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $77.62 | Professional | 53 · Discontinued | $36.31 | $47.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $288.40 | Professional | 54 · Surgery only | $134.90 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $169.82 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $125.89 | $169.82 | $269.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $323.59 Median $1,318.26 Typical High $2,511.89 | Facility | 50 · Both sides | $323.59 | $1,318.26 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $407.38 Typical High $707.95 | Professional | 50 · Both sides | $338.84 | $407.38 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $407.38 | Professional | 54 · Surgery only | $204.17 | $245.47 | $407.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $457.09 Typical High $562.34 | Professional | 63 · Small infant | $281.84 | $457.09 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $120.23 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $120.23 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $77.62 | Professional | 53 · Discontinued | $36.31 | $47.86 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $288.40 | Professional | 54 · Surgery only | $134.90 | $181.97 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $169.82 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $125.89 | $169.82 | $269.15 |
Where Idaho sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 17th of 51
$269
WI $575KY $162
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.