How much rates vary
Facilitymedian $1,175 · 10th to 90th $479 to $4,169Professionalmedian $1,047 · 10th to 90th $661 to $1,259
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 $1,047.13 Median $1,258.93 Typical High $4,466.84 | Facility | None | $1,047.13 | $1,258.93 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,202.26 | Professional | None | $602.56 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $501.19 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $467.74 | $741.31 | $776.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $467.74 Median $1,174.90 Typical High $4,168.69 | Facility | None | $467.74 | $1,174.90 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,318.26 | Professional | None | $954.99 | $1,122.02 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $660.69 | $812.83 | $933.25 |
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 $630.96 Median $741.31 Typical High $851.14 | Professional | None | $630.96 | $741.31 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $4,466.84 | Facility | None | $660.69 | $1,318.26 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,318.26 | Professional | None | $691.83 | $1,047.13 | $1,318.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $501.19 | $794.33 | $831.76 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $467.74 | $741.31 | $776.25 |
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 $1,000.00 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,047.13 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,202.26 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $812.83 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $912.01 |
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 $954.99 Median $1,122.02 Typical High $1,318.26 | Professional | None | $954.99 | $1,122.02 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $1,023.29 | Facility | None | $575.44 | $588.84 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $977.24 | Professional | None | $524.81 | $575.44 | $977.24 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,122.02 | Professional | None | $562.34 | $758.58 | $1,122.02 |
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 $331.13 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $331.13 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $100.00 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $66.07 | $104.71 | $109.65 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $707.95 Median $1,778.28 Typical High $6,309.57 | Facility | 50 · Both sides | $707.95 | $1,778.28 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $1,995.26 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $131.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,348.96 Typical High $1,584.89 | Professional | 63 · Small infant | $1,174.90 | $1,348.96 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $331.13 | $524.81 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $208.93 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $100.00 | $158.49 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $66.07 | $104.71 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,737.80 Typical High $1,819.70 | Professional | 50 · Both sides | $1,737.80 | $1,737.80 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $123.03 |
Where Idaho sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.