How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,259 to $16,218Professionalmedian $1,259 · 10th to 90th $813 to $1,445
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $1,348.96 | Professional | None | $741.31 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $645.65 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $954.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $18,620.87 | Facility | None | $2,454.71 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,023.29 | Professional | None | $776.25 | $912.01 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $5,495.41 | Facility | None | $812.83 | $1,348.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,584.89 | Professional | None | $851.14 | $1,348.96 | $1,584.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $645.65 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $954.99 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,023.29 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,348.96 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $6,309.57 | Facility | None | $602.56 | $616.60 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $4,168.69 | Professional | None | $602.56 | $691.83 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,412.54 | Professional | None | $724.44 | $977.24 | $1,412.54 |
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 $426.58 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $426.58 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $85.11 | $134.90 | $134.90 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,548.13 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $3,548.13 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,949.84 Typical High $2,089.30 | Professional | 50 · Both sides | $1,737.80 | $1,949.84 | $2,089.30 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 62 · Two surgeons | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 63 · Small infant | $1,380.38 | $1,548.82 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $426.58 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $169.82 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $85.11 | $134.90 | $134.90 |
Where Idaho sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.