How much rates vary
Facilitymedian $145 · 10th to 90th $49 to $195Professionalmedian $126 · 10th to 90th $46 to $219
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $43.65 Median $48.98 Typical High $48.98 | Professional | None | $43.65 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $21.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $8.71 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $4.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $977.24 | Professional | None | $141.25 | $151.36 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $323.59 | Facility | None | $141.25 | $144.54 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $48.98 Typical High $70.79 | Facility | None | $38.90 | $48.98 | $70.79 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $223.87 | Professional | None | $43.65 | $48.98 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $21.38 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $8.71 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $4.90 |
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 $147.91 Median $147.91 Typical High $194.98 | Facility | None | $147.91 | $147.91 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $213.80 | Professional | None | $125.89 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $97.72 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $97.72 | $177.83 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 22 · Increased work | $154.88 | $154.88 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $97.72 | $97.72 | $97.72 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 63 · Small infant | $154.88 | $154.88 | $154.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $104.71 |
Where Idaho sits
The same service costs 25.1 times more in Wyoming 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· 18th of 51
$126
WY $977KY $38.90
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.