How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,445 to $17,378Professionalmedian $1,479 · 10th to 90th $1,023 to $1,820
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 $870.96 Median $1,659.59 Typical High $1,659.59 | Professional | None | $870.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $18,620.87 | Facility | None | $3,467.37 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,348.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,348.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $162.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,148.15 |
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 $977.24 Median $1,122.02 Typical High $1,288.25 | Professional | None | $977.24 | $1,122.02 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,659.59 Typical High $5,495.41 | Facility | None | $933.25 | $1,659.59 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,659.59 | $1,949.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $741.31 | $1,174.90 | $1,174.90 |
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 $1,202.26 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,202.26 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,445.44 | $1,862.09 |
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 $1,479.11 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,659.59 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $8,709.64 | Facility | None | $691.83 | $707.95 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $4,168.69 | Professional | None | $691.83 | $831.76 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,737.80 | Professional | None | $870.96 | $1,174.90 | $1,737.80 |
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 $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $5,128.61 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $5,128.61 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,238.72 Typical High $2,454.71 | Professional | 50 · Both sides | $2,041.74 | $2,238.72 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $933.25 Typical High $1,023.29 | Professional | 62 · Two surgeons | $851.14 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,819.70 Typical High $1,949.84 | Professional | 63 · Small infant | $1,621.81 | $1,819.70 | $1,949.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 5.3 times more in Colorado 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
CO $14,031MT $2,637
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.