How much rates vary
Facilitymedian $1,202 · 10th to 90th $676 to $4,169Professionalmedian $1,445 · 10th to 90th $912 to $1,660
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 $776.25 Median $1,548.82 Typical High $1,548.82 | Professional | None | $776.25 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $144.54 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $1,071.52 | $1,071.52 |
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 $1,288.25 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $162.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,122.02 |
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 $912.01 Median $1,047.13 Typical High $1,174.90 | Professional | None | $912.01 | $1,047.13 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,548.82 Typical High $5,495.41 | Facility | None | $794.33 | $1,548.82 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,819.70 | Professional | None | $954.99 | $1,548.82 | $1,819.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $144.54 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $1,071.52 | $1,071.52 |
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 $1,174.90 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,445.44 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
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 $1,288.25 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,513.56 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $2,884.03 | Facility | None | $691.83 | $691.83 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,148.15 | Professional | None | $691.83 | $758.58 | $1,148.15 |
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 $831.76 Median $1,122.02 Typical High $1,621.81 | Professional | None | $831.76 | $1,122.02 | $1,621.81 |
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 $478.63 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $478.63 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $190.55 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $95.50 | $154.88 | $154.88 |
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 $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | 50 · Both sides | $1,995.26 | $2,238.72 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 63 · Small infant | $1,584.89 | $1,778.28 | $1,949.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $478.63 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $190.55 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $95.50 | $154.88 | $154.88 |
Where Idaho sits
The same service costs 3.6 times more in Alaska than in Alabama. 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
AK $5,545AL $1,558
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.