How much rates vary
Facilitymedian $1,585 · 10th to 90th $794 to $6,457Professionalmedian $794 · 10th to 90th $537 to $1,122
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 $1,288.25 Typical High $5,495.41 | Facility | None | $954.99 | $1,288.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,096.48 | Professional | None | $501.19 | $794.33 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $602.56 Typical High $812.83 | Professional | 54 · Surgery only | $380.19 | $602.56 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $354.81 | $562.34 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $7,413.10 | Facility | None | $1,479.11 | $2,630.27 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,148.15 | Professional | None | $676.08 | $870.96 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $588.84 | $851.14 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $851.14 | Professional | None | $501.19 | $616.60 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,096.48 Typical High $5,754.40 | Facility | None | $501.19 | $1,096.48 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,096.48 | Professional | None | $562.34 | $891.25 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $602.56 Typical High $812.83 | Professional | 54 · Surgery only | $380.19 | $602.56 | $812.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $354.81 | $562.34 | $758.58 |
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 $707.95 Median $707.95 Typical High $1,047.13 | Facility | None | $707.95 | $707.95 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,318.26 | Professional | None | $707.95 | $912.01 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | 54 · Surgery only | $602.56 | $602.56 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,258.93 | Professional | None | $794.33 | $933.25 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $3,311.31 | Facility | None | $501.19 | $512.86 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,412.54 | Professional | None | $389.05 | $501.19 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,023.29 | Professional | None | $426.58 | $645.65 | $1,023.29 |
14 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 $251.19 Median $398.11 Typical High $549.54 | Professional | 52 · Reduced service | $251.19 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | 53 · Discontinued | $100.00 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $50.12 | $79.43 | $109.65 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,137.96 Median $3,548.13 Typical High $11,220.18 | Facility | 50 · Both sides | $2,137.96 | $3,548.13 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,445.44 Typical High $1,737.80 | Professional | 50 · Both sides | $1,023.29 | $1,445.44 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $112.20 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $112.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $812.83 Median $1,148.15 Typical High $1,380.38 | Professional | 63 · Small infant | $812.83 | $1,148.15 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $398.11 Typical High $549.54 | Professional | 52 · Reduced service | $251.19 | $398.11 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | 53 · Discontinued | $100.00 | $158.49 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $50.12 | $79.43 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $1,288.25 | $1,288.25 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $114.82 |
Where Idaho sits
The same service costs 4.7 times more in Colorado 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
CO $6,464MT $1,390
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.