How much rates vary
Facilitymedian $1,000 · 10th to 90th $339 to $4,169Professionalmedian $316 · 10th to 90th $182 to $813
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 $208.93 Median $724.44 Typical High $5,495.41 | Facility | None | $208.93 | $724.44 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $407.38 Typical High $812.83 | Professional | None | $162.18 | $407.38 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $281.84 Typical High $616.60 | Professional | 54 · Surgery only | $120.23 | $281.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $56.23 Typical High $123.03 | Professional | 55 · Aftercare only | $24.55 | $56.23 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,819.70 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $776.25 | Professional | None | $213.80 | $537.03 | $776.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $257.04 Typical High $676.08 | Professional | 54 · Surgery only | $190.55 | $257.04 | $676.08 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $79.43 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $645.65 | Professional | None | $181.97 | $251.19 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $812.83 Typical High $5,495.41 | Facility | None | $208.93 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $562.34 Typical High $933.25 | Professional | None | $186.21 | $562.34 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $616.60 | Professional | 54 · Surgery only | $120.23 | $204.17 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $40.74 Typical High $123.03 | Professional | 55 · Aftercare only | $24.55 | $40.74 | $123.03 |
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 $223.87 Median $223.87 Typical High $707.95 | Facility | None | $223.87 | $223.87 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $891.25 | Professional | None | $223.87 | $288.40 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $588.84 | Professional | 54 · Surgery only | $199.53 | $199.53 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $933.25 | Professional | None | $251.19 | $457.09 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $3,388.44 | Facility | None | $338.84 | $346.74 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $338.84 Typical High $831.76 | Professional | None | $131.83 | $338.84 | $831.76 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $144.54 Median $354.81 Typical High $933.25 | Professional | None | $144.54 | $354.81 | $933.25 |
10 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 $81.28 Median $186.21 Typical High $407.38 | Professional | 52 · Reduced service | $81.28 | $186.21 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $75.86 Typical High $162.18 | Professional | 53 · Discontinued | $32.36 | $75.86 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $37.15 Typical High $81.28 | Professional | 56 · Pre-op care only | $16.22 | $37.15 | $81.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $288.40 Typical High $933.25 | Professional | 63 · Small infant | $245.47 | $288.40 | $933.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $147.91 | $446.68 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $134.90 Typical High $407.38 | Professional | 52 · Reduced service | $81.28 | $134.90 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $53.70 Typical High $162.18 | Professional | 53 · Discontinued | $32.36 | $53.70 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.92 Typical High $81.28 | Professional | 56 · Pre-op care only | $16.22 | $26.92 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $83.18 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $630.96 |
Where Idaho sits
The same service costs 5.1 times more in Colorado than in North Dakota. 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 $4,353ND $853
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.