How much rates vary
Facilitymedian $1,000 · 10th to 90th $575 to $4,266Professionalmedian $741 · 10th to 90th $457 to $1,202
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 $794.33 Median $1,348.96 Typical High $5,495.41 | Facility | None | $794.33 | $1,348.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,122.02 | Professional | None | $436.52 | $676.08 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $851.14 | Professional | 54 · Surgery only | $323.59 | $501.19 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $169.82 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $794.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,905.46 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,230.27 | Professional | None | $575.44 | $870.96 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $1,096.48 | Professional | 54 · Surgery only | $512.86 | $630.96 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $74.13 Typical High $120.23 | Professional | 55 · Aftercare only | $57.54 | $74.13 | $120.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | None | $446.68 | $575.44 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $794.33 Typical High $4,466.84 | Facility | None | $436.52 | $794.33 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,288.25 | Professional | None | $524.81 | $794.33 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $851.14 | Professional | 54 · Surgery only | $323.59 | $501.19 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $169.82 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $794.33 |
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 $616.60 Median $616.60 Typical High $1,122.02 | Facility | None | $616.60 | $616.60 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,412.54 | Professional | None | $616.60 | $776.25 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $851.14 | Professional | 54 · Surgery only | $524.81 | $524.81 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $912.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,318.26 | Professional | None | $676.08 | $794.33 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $3,715.35 | Facility | None | $537.03 | $549.54 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $831.76 | Professional | None | $338.84 | $537.03 | $831.76 |
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 $363.08 Median $575.44 Typical High $977.24 | Professional | None | $363.08 | $575.44 | $977.24 |
8 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 $338.84 Typical High $562.34 | Professional | 52 · Reduced service | $213.80 | $338.84 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $134.90 Typical High $223.87 | Professional | 53 · Discontinued | $87.10 | $134.90 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $112.20 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $812.83 Typical High $1,445.44 | Professional | 63 · Small infant | $691.83 | $812.83 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $338.84 Typical High $562.34 | Professional | 52 · Reduced service | $213.80 | $338.84 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $134.90 Typical High $223.87 | Professional | 53 · Discontinued | $87.10 | $134.90 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $112.20 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $120.23 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $120.23 |
Where Idaho sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.