How much rates vary
Facilitymedian $1,413 · 10th to 90th $759 to $4,898Professionalmedian $708 · 10th to 90th $457 to $851
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 $645.65 Median $4,466.84 Typical High $7,244.36 | Facility | None | $645.65 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $776.25 Typical High $776.25 | Professional | None | $398.11 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,174.90 | $2,630.27 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $794.33 | Professional | None | $660.69 | $776.25 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $660.69 | $724.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $79.43 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $562.34 |
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 $446.68 Median $524.81 Typical High $602.56 | Professional | None | $446.68 | $524.81 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $5,495.41 | Facility | None | $457.09 | $776.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $933.25 | Professional | None | $501.19 | $776.25 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $549.54 |
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 $575.44 Median $707.95 Typical High $707.95 | Facility | None | $575.44 | $707.95 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | None | $707.95 | $707.95 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $933.25 | Professional | None | $691.83 | $794.33 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $5,248.07 | Facility | None | $338.84 | $346.74 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $977.24 | Professional | None | $338.84 | $389.05 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $812.83 | Professional | None | $407.38 | $549.54 | $812.83 |
9 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 $251.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $77.62 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,801.89 Typical High $7,413.10 | Facility | 50 · Both sides | $1,778.28 | $3,801.89 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | 50 · Both sides | $977.24 | $1,096.48 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $794.33 Median $891.25 Typical High $954.99 | Professional | 63 · Small infant | $794.33 | $891.25 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $251.19 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $100.00 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $77.62 |
Where Idaho sits
The same service costs 3.9 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 $4,902MT $1,262
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.