How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,230 to $9,772Professionalmedian $1,047 · 10th to 90th $661 to $1,288
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 $954.99 Median $3,388.44 Typical High $8,709.64 | Facility | None | $954.99 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $1,174.90 | Professional | None | $588.84 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $831.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $4,265.80 Typical High $9,332.54 | Facility | None | $2,187.76 | $4,265.80 | $9,332.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,174.90 | Professional | None | $977.24 | $1,148.15 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $117.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $912.01 | Professional | None | $660.69 | $794.33 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $3,981.07 Typical High $19,054.61 | Facility | None | $741.31 | $3,981.07 | $19,054.61 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,380.38 | Professional | None | $741.31 | $1,174.90 | $1,380.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $562.34 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $112.20 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $831.76 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Facility | None | $851.14 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $8,317.64 Typical High $10,715.19 | Facility | None | $5,495.41 | $8,317.64 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,174.90 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $9,549.93 | Facility | None | $501.19 | $512.86 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,862.09 | Professional | None | $501.19 | $588.84 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,230.27 | Professional | None | $602.56 | $831.76 | $1,230.27 |
7 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 $371.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $74.13 | $117.49 | $117.49 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,174.90 Median $1,318.26 Typical High $1,412.54 | Professional | 63 · Small infant | $1,174.90 | $1,318.26 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $74.13 | $117.49 | $117.49 |
Where Idaho sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.