How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $8,710Professionalmedian $794 · 10th to 90th $525 to $1,122
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 $758.58 Median $1,023.29 Typical High $5,495.41 | Facility | None | $758.58 | $1,023.29 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $912.01 | Professional | None | $446.68 | $691.83 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,862.09 | $3,090.30 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,318.26 | Professional | None | $707.95 | $933.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,737.80 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $891.25 | Professional | None | $616.60 | $707.95 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,023.29 Typical High $9,549.93 | Facility | None | $588.84 | $1,023.29 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,071.52 | Professional | None | $588.84 | $794.33 | $1,071.52 |
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 $794.33 Median $794.33 Typical High $1,122.02 | Facility | None | $794.33 | $794.33 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None | $794.33 | $1,000.00 | $1,202.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,709.64 Typical High $12,589.25 | Facility | None | $6,165.95 | $8,709.64 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $933.25 | Professional | None | $707.95 | $891.25 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $4,570.88 | Facility | None | $575.44 | $588.84 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $724.44 | Professional | None | $549.54 | $575.44 | $724.44 |
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 $478.63 Median $707.95 Typical High $977.24 | Professional | None | $478.63 | $707.95 | $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 $281.84 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $281.84 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $112.20 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $56.23 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $602.56 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $4,365.16 Typical High $14,791.08 | Facility | 50 · Both sides | $2,754.23 | $4,365.16 | $14,791.08 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | 50 · Both sides | $1,202.26 | $1,445.44 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,000.00 Typical High $1,230.27 | Professional | 54 · Surgery only | $707.95 | $1,000.00 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $134.90 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $812.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,122.02 Typical High $1,584.89 | Professional | 63 · Small infant | $954.99 | $1,122.02 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $295.12 | $346.74 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $117.49 | $138.04 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $524.81 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $58.88 | $69.18 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $602.56 |
Where Idaho sits
The same service costs 4.7 times more in Vermont 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.
Physician feeFacility fee
VT $7,643MT $1,633
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.