How much rates vary
Facilitymedian $1,698 · 10th to 90th $759 to $7,413Professionalmedian $617 · 10th to 90th $437 to $759
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 $851.14 Median $2,884.03 Typical High $7,762.47 | Facility | None | $851.14 | $2,884.03 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | None | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $323.59 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $64.57 | $107.15 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $7,413.10 | Facility | None | $1,698.24 | $3,162.28 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | None | $537.03 | $630.96 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $549.54 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $66.07 |
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 $436.52 Median $501.19 Typical High $575.44 | Professional | None | $436.52 | $501.19 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $851.14 Typical High $9,549.93 | Facility | None | $436.52 | $851.14 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $812.83 | Professional | None | $467.74 | $707.95 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $323.59 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $64.57 | $107.15 | $107.15 |
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 $478.63 Median $588.84 Typical High $588.84 | Facility | None | $478.63 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | None | $588.84 | $588.84 | $758.58 |
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 $645.65 Median $676.08 Typical High $812.83 | Professional | None | $645.65 | $676.08 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $4,073.80 | Facility | None | $281.84 | $281.84 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $1,412.54 | Professional | None | $281.84 | $338.84 | $1,412.54 |
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 $380.19 Median $645.65 Typical High $1,288.25 | Professional | None | $380.19 | $645.65 | $1,288.25 |
8 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 $218.78 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $218.78 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $87.10 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $43.65 | $70.79 | $70.79 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 63 · Small infant | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $426.58 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $218.78 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $87.10 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $43.65 | $70.79 | $70.79 |
Where Idaho sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.