How much rates vary
Facilitymedian $1,072 · 10th to 90th $269 to $4,169Professionalmedian $708 · 10th to 90th $427 to $813
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 $467.74 Median $724.44 Typical High $724.44 | Professional | None | $467.74 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $346.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $501.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,168.69 | Facility | None | $363.08 | $1,174.90 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | None | $645.65 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $660.69 | $707.95 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $79.43 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $549.54 |
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 $380.19 Median $478.63 Typical High $537.03 | Professional | None | $380.19 | $478.63 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $5,495.41 | Facility | None | $338.84 | $724.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $851.14 | Professional | None | $467.74 | $724.44 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $346.74 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $323.59 | $501.19 | $501.19 |
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 $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 $645.65 Median $741.31 Typical High $851.14 | Professional | None | $645.65 | $741.31 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $1,659.59 | Facility | None | $338.84 | $338.84 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $977.24 | Professional | None | $338.84 | $371.54 | $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 $346.74 Median $489.78 Typical High $724.44 | Professional | None | $346.74 | $489.78 | $724.44 |
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 $234.42 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $93.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $72.44 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $537.03 Median $1,778.28 Typical High $6,309.57 | Facility | 50 · Both sides | $537.03 | $1,778.28 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 50 · Both sides | $977.24 | $1,096.48 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | 63 · Small infant | $776.25 | $870.96 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $93.33 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $72.44 | $72.44 |
Where Idaho sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.