How much rates vary
Facilitymedian $1,072 · 10th to 90th $302 to $4,467Professionalmedian $851 · 10th to 90th $525 to $1,047
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $912.01 | Professional | None | $489.78 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $398.11 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $371.54 | $575.44 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $371.54 Median $1,174.90 Typical High $4,897.79 | Facility | None | $371.54 | $1,174.90 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,122.02 | Professional | None | $776.25 | $912.01 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $691.83 | $831.76 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $691.83 | Professional | None | $489.78 | $616.60 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $6,456.54 | Facility | None | $489.78 | $912.01 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,071.52 | Professional | None | $588.84 | $870.96 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $398.11 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $371.54 | $575.44 | $645.65 |
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 $831.76 Median $851.14 Typical High $1,023.29 | Facility | None | $831.76 | $851.14 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | None | $851.14 | $1,023.29 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,096.48 | Professional | None | $794.33 | $933.25 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $1,698.24 | Facility | None | $489.78 | $501.19 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $977.24 | Professional | None | $416.87 | $489.78 | $977.24 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $891.25 | Professional | None | $436.52 | $602.56 | $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 $263.03 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $263.03 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $104.71 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $79.43 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $91.20 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $537.03 Median $1,778.28 Typical High $7,244.36 | Facility | 50 · Both sides | $537.03 | $1,778.28 | $7,244.36 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,380.38 Typical High $1,584.89 | Professional | 50 · Both sides | $1,148.15 | $1,380.38 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $977.24 Median $1,096.48 Typical High $1,318.26 | Professional | 63 · Small infant | $977.24 | $1,096.48 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $263.03 | $416.87 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $104.71 | $165.96 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $79.43 | $123.03 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $91.20 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | 50 · Both sides | $1,380.38 | $1,380.38 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $102.33 |
Where Idaho sits
The same service costs 4.9 times more in Colorado than in Delaware. 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 $4,364DE $899
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.