How much rates vary
Facilitymedian $2,951 · 10th to 90th $2,570 to $4,169Professionalmedian $2,818 · 10th to 90th $2,570 to $3,162
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 $2,570.40 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,570.40 | $3,162.28 | $3,162.28 |
BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,168.69 | Facility | None | $2,570.40 | $2,951.21 | $4,168.69 |
BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,570.40 | $2,818.38 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $6,456.54 | Facility | None | $2,818.38 | $2,884.03 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,570.40 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,570.40 | $3,019.95 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,715.35 | Facility | None | $2,818.38 | $2,818.38 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,951.21 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $6,025.60 | Facility | None | $2,570.40 | $3,548.13 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,570.40 | $3,019.95 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $5,370.32 | Facility | None | $2,570.40 | $2,570.40 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,570.40 | $2,630.27 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,454.71 | $2,454.71 | $2,570.40 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,288.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $512.86 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,949.84 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $257.04 | $316.23 | $316.23 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,318.26 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $537.03 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,995.26 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $398.11 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $263.03 | $302.00 | $302.00 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 3rd of 51
$2,818
AK $3,020DC $2,570
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.