How much rates vary
Facilitymedian $372 · 10th to 90th $166 to $1,318Professionalmedian $324 · 10th to 90th $162 to $646
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 $281.84 Typical High $346.74 | Professional | None | $141.25 | $281.84 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,318.26 | Facility | None | $467.74 | $794.33 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $575.44 Typical High $676.08 | Professional | None | $269.15 | $575.44 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $338.84 Typical High $5,495.41 | Facility | None | $151.36 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $549.54 | Professional | None | $162.18 | $338.84 | $549.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $501.19 | Facility | None | $165.96 | $269.15 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $616.60 | Professional | None | $165.96 | $316.23 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,318.26 | Facility | None | $524.81 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $602.56 | Professional | None | $269.15 | $346.74 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $398.11 | Professional | None | $194.98 | $295.12 | $398.11 |
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 $229.09 Median $436.52 Typical High $794.33 | Professional | None | $229.09 | $436.52 | $794.33 |
11 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 $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $70.79 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $28.18 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $107.15 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $34.67 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $398.11 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $223.87 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $70.79 | $114.82 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $28.18 | $45.71 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $263.03 | Professional | 54 · Surgery only | $107.15 | $169.82 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $52.48 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $34.67 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin 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· 37th of 51
$339
WI $813UT $288
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.