How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $7,762Professionalmedian $2,188 · 10th to 90th $1,380 to $2,754
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 $1,584.89 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,584.89 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,202.26 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,715.35 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,715.35 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,041.74 | $2,398.83 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $245.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $5,495.41 | Facility | None | $1,047.13 | $2,570.40 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,570.40 | $3,019.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,202.26 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $239.88 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,778.28 | $1,778.28 |
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 $1,778.28 Median $2,187.76 Typical High $2,187.76 | Facility | None | $1,778.28 | $2,187.76 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,511.89 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $6,309.57 | Facility | None | $1,047.13 | $1,071.52 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
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 $1,380.38 Typical High $2,454.71 | Professional | None | $724.44 | $1,380.38 | $2,454.71 |
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 $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $316.23 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $158.49 | $257.04 | $257.04 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $5,370.32 Typical High $12,589.25 | Facility | 50 · Both sides | $3,311.31 | $5,370.32 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,388.44 Typical High $3,715.35 | Professional | 50 · Both sides | $3,019.95 | $3,388.44 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,258.93 | $1,412.54 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,454.71 Median $2,691.53 Typical High $2,951.21 | Professional | 63 · Small infant | $2,454.71 | $2,691.53 | $2,951.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $794.33 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $316.23 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $158.49 | $257.04 | $257.04 |
Where Idaho sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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 $9,494KY $2,537
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.