How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,514 to $17,378Professionalmedian $1,585 · 10th to 90th $1,096 to $1,995
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 $2,137.96 Median $4,466.84 Typical High $8,709.64 | Facility | None | $2,137.96 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,862.09 Typical High $1,862.09 | Professional | None | $912.01 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $870.96 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,630.27 Median $8,709.64 Typical High $21,877.62 | Facility | None | $2,630.27 | $8,709.64 | $21,877.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $177.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,258.93 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $7,585.78 | Facility | None | $758.58 | $2,137.96 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,862.09 | $2,187.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $870.96 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $173.78 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,288.25 |
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 $1,318.26 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,318.26 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,584.89 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,819.70 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $7,413.10 | Facility | None | $758.58 | $776.25 | $7,413.10 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $4,168.69 | Professional | None | $758.58 | $912.01 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,318.26 | $1,949.84 |
10 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 $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $229.09 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $114.82 | $186.21 | $186.21 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,890.45 Median $13,489.63 Typical High $32,359.37 | Facility | 50 · Both sides | $3,890.45 | $13,489.63 | $32,359.37 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,454.71 Typical High $2,691.53 | Professional | 50 · Both sides | $2,238.72 | $2,454.71 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | 62 · Two surgeons | $933.25 | $1,023.29 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $1,995.26 Typical High $2,137.96 | Professional | 63 · Small infant | $1,778.28 | $1,995.26 | $2,137.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $229.09 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $114.82 | $186.21 | $186.21 |
Where Idaho sits
The same service costs 6.0 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 $12,479KY $2,087
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.