How much rates vary
Facilitymedian $1,698 · 10th to 90th $759 to $6,457Professionalmedian $851 · 10th to 90th $603 to $1,202
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 $812.83 Median $1,148.15 Typical High $5,495.41 | Facility | None | $812.83 | $1,148.15 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $954.99 | Professional | None | $501.19 | $707.95 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $7,413.10 | Facility | None | $1,698.24 | $2,818.38 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,445.44 | Professional | None | $691.83 | $954.99 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $977.24 | Professional | None | $549.54 | $691.83 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $5,495.41 | Facility | None | $575.44 | $954.99 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,202.26 | Professional | None | $676.08 | $851.14 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $724.44 Typical High $1,122.02 | Facility | None | $691.83 | $724.44 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,318.26 | Professional | None | $724.44 | $851.14 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,202.26 | Professional | None | $691.83 | $851.14 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $4,786.30 | Facility | None | $630.96 | $645.65 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | None | $630.96 | $630.96 | $776.25 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $977.24 | Professional | None | $467.74 | $660.69 | $977.24 |
19 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 $338.84 Median $338.84 Typical High $478.63 | Professional | 52 · Reduced service | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $851.14 Typical High $1,230.27 | Professional | 54 · Surgery only | $676.08 | $851.14 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $125.89 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $125.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | 63 · Small infant | $933.25 | $1,096.48 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 52 · Reduced service | $338.84 | $338.84 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $134.90 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $512.86 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | 54 · Surgery only | $524.81 | $524.81 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $794.33 |
Where Idaho sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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.
Physician feeFacility fee
CO $6,580WV $1,277
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.