How much rates vary
Facilitymedian $1,413 · 10th to 90th $1,259 to $3,236Professionalmedian $1,259 · 10th to 90th $302 to $1,288
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 $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $1,348.96 Typical High $1,348.96 | Professional | None | $302.00 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $3,467.37 | Facility | None | $1,412.54 | $1,445.44 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,288.25 Typical High $1,819.70 | Facility | None | $288.40 | $1,288.25 | $1,819.70 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
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 Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,584.89 | Professional | None | $302.00 | $302.00 | $1,584.89 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $213.80 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $213.80 | $912.01 | $954.99 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 22 · Increased work | $331.13 | $331.13 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 63 · Small infant | $331.13 | $331.13 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $229.09 |
Where Idaho sits
The same service costs 6.9 times more in Alaska 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· 36th of 51
$1,259
AK $1,995KY $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.