How much rates vary
Facilitymedian $1,000 · 10th to 90th $562 to $4,266Professionalmedian $692 · 10th to 90th $447 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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $1,071.52 | Professional | None | $407.38 | $676.08 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $316.23 | $501.19 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $295.12 | $467.74 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,995.26 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,148.15 | Professional | None | $562.34 | $812.83 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $1,023.29 | Professional | 54 · Surgery only | $512.86 | $616.60 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $794.33 |
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 $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,466.84 | Facility | None | $295.12 | $954.99 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,202.26 | Professional | None | $524.81 | $776.25 | $1,202.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $316.23 | $501.19 | $794.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $295.12 | $467.74 | $741.31 |
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 $616.60 Median $616.60 Typical High $1,071.52 | Facility | None | $616.60 | $616.60 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,348.96 | Professional | None | $616.60 | $776.25 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $794.33 | Professional | 54 · Surgery only | $512.86 | $512.86 | $794.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $851.14 |
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 $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $3,715.35 | Facility | None | $512.86 | $512.86 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $831.76 | Professional | None | $331.13 | $512.86 | $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 $354.81 Median $549.54 Typical High $891.25 | Professional | None | $354.81 | $549.54 | $891.25 |
14 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 $208.93 Median $331.13 Typical High $537.03 | Professional | 52 · Reduced service | $208.93 | $331.13 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | 53 · Discontinued | $85.11 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $158.49 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $67.61 Typical High $107.15 | Professional | 56 · Pre-op care only | $42.66 | $67.61 | $107.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,479.11 Median $2,884.03 Typical High $6,309.57 | Facility | 50 · Both sides | $1,479.11 | $2,884.03 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,096.48 Typical High $1,737.80 | Professional | 50 · Both sides | $851.14 | $1,096.48 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $56.23 | $95.50 | $114.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $707.95 Median $831.76 Typical High $1,348.96 | Professional | 63 · Small infant | $707.95 | $831.76 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $331.13 Typical High $537.03 | Professional | 52 · Reduced service | $208.93 | $331.13 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | 53 · Discontinued | $85.11 | $134.90 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $158.49 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $67.61 Typical High $107.15 | Professional | 56 · Pre-op care only | $42.66 | $67.61 | $107.15 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,096.48 Typical High $1,698.24 | Professional | 50 · Both sides | $1,096.48 | $1,096.48 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $112.20 |
Where Idaho sits
The same service costs 4.5 times more in Colorado than in Maryland. 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 $4,866MD $1,088
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.