How much rates vary
Facilitymedian $219 · 10th to 90th $102 to $490Professionalmedian $309 · 10th to 90th $132 to $339
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 $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $229.09 Typical High $489.78 | Facility | None | $102.33 | $229.09 | $489.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $870.96 | Facility | None | $354.81 | $457.09 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $316.23 Typical High $457.09 | Facility | None | $12.02 | $316.23 | $457.09 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
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 $131.83 Median $151.36 Typical High $218.78 | Facility | None | $131.83 | $151.36 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $251.19 | Professional | None | $128.82 | $151.36 | $251.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $257.04 | Facility | None | $22.91 | $22.91 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $562.34 | Facility | None | $346.74 | $398.11 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | None | $331.13 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | None | $309.03 | $309.03 | $331.13 |
5 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 22 · Increased work | $407.38 | $407.38 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 63 · Small infant | $407.38 | $407.38 | $407.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $275.42 |
Where Idaho sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 44th of 51
$309
AK $468MT $204
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.