How much rates vary
Facilitymedian $275 · 10th to 90th $48 to $955Professionalmedian $48 · 10th to 90th $31 to $69
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 Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $38.02 | Professional | None | $25.70 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.50 Typical High $21.88 | Professional | 52 · Reduced service | $19.05 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $8.71 | Professional | 53 · Discontinued | $7.59 | $7.94 | $8.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $63.10 Median $281.84 Typical High $812.83 | Facility | None | $63.10 | $281.84 | $812.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $72.44 | Professional | None | $47.86 | $48.98 | $72.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $48.98 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $33.88 | $48.98 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $39.81 | Professional | None | $36.31 | $38.90 | $39.81 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $39.81 Typical High $56.23 | Facility | None | $25.12 | $39.81 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $61.66 | Professional | None | $38.90 | $50.12 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 52 · Reduced service | $19.50 | $19.50 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.71 |
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 $48.98 Median $57.54 Typical High $57.54 | Facility | None | $48.98 | $57.54 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $7.94 Median $57.54 Typical High $58.88 | Professional | None | $7.94 | $57.54 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $36.31 | $36.31 | $36.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $741.31 Typical High $1,023.29 | Facility | None | $512.86 | $741.31 | $1,023.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | None | $47.86 | $47.86 | $50.12 |
Select Health Setting Facility Modifier None Typical Low $32.36 Median $33.11 Typical High $275.42 | Facility | None | $32.36 | $33.11 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $58.88 | Professional | None | $31.62 | $32.36 | $58.88 |
United Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $52.48 | Professional | None | $28.18 | $38.02 | $52.48 |
4 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 22 · Increased work | $53.70 | $53.70 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 54 · Surgery only | $33.88 | $33.88 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 63 · Small infant | $53.70 | $53.70 | $53.70 |
Where Idaho sits
The same service costs 3.6 times more in Minnesota 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· 12th of 51
$47.86
MN $69.18KY $19.05
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.