How much rates vary
Facilitymedian $1,175 · 10th to 90th $562 to $4,169Professionalmedian $603 · 10th to 90th $407 to $724
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 $426.58 Median $660.69 Typical High $660.69 | Professional | None | $426.58 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $4,168.69 | Facility | None | $1,174.90 | $1,905.46 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $676.08 | Professional | None | $562.34 | $660.69 | $676.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $562.34 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $67.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $478.63 |
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 $354.81 Median $446.68 Typical High $512.86 | Professional | None | $354.81 | $446.68 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $660.69 Typical High $5,495.41 | Facility | None | $316.23 | $660.69 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $776.25 | Professional | None | $426.58 | $660.69 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $457.09 |
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 $489.78 Median $602.56 Typical High $602.56 | Facility | None | $489.78 | $602.56 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | None | $602.56 | $602.56 | $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 $602.56 Median $660.69 Typical High $776.25 | Professional | None | $602.56 | $660.69 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $3,801.89 | Facility | None | $288.40 | $295.12 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $977.24 | Professional | None | $288.40 | $331.13 | $977.24 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $660.69 | Professional | None | $331.13 | $457.09 | $660.69 |
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 $213.80 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $213.80 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $66.07 | $66.07 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $2,818.38 Typical High $6,309.57 | Facility | 50 · Both sides | $1,778.28 | $2,818.38 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | 50 · Both sides | $831.76 | $933.25 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 63 · Small infant | $676.08 | $741.31 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $213.80 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $66.07 | $66.07 |
Where Idaho sits
The same service costs 4.6 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 $4,822MT $1,050
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.