How much rates vary
Facilitymedian $2,042 · 10th to 90th $661 to $7,244Professionalmedian $490 · 10th to 90th $347 to $603
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 $660.69 Median $1,412.54 Typical High $7,079.46 | Facility | None | $660.69 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $562.34 | Professional | None | $288.40 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $263.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $52.48 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $8,511.38 | Facility | None | $1,584.89 | $2,754.23 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $549.54 | Professional | None | $457.09 | $537.03 | $549.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $457.09 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $54.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $316.23 | $354.81 | $389.05 |
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 $331.13 Median $380.19 Typical High $436.52 | Professional | None | $331.13 | $380.19 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $660.69 Typical High $7,244.36 | Facility | None | $346.74 | $660.69 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $645.65 | Professional | None | $346.74 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $263.03 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $52.48 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $389.05 |
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 $398.11 Median $489.78 Typical High $489.78 | Facility | None | $398.11 | $489.78 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | None | $489.78 | $489.78 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | None | $489.78 | $537.03 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $3,890.45 | Facility | None | $234.42 | $239.88 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $1,862.09 | Professional | None | $234.42 | $275.42 | $1,862.09 |
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 $302.00 Median $416.87 Typical High $588.84 | Professional | None | $302.00 | $416.87 | $588.84 |
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 $173.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $173.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $69.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $56.23 | $56.23 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,715.35 Typical High $12,589.25 | Facility | 50 · Both sides | $2,344.23 | $3,715.35 | $12,589.25 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $758.58 Typical High $831.76 | Professional | 50 · Both sides | $691.83 | $758.58 | $831.76 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $316.23 Typical High $346.74 | Professional | 62 · Two surgeons | $288.40 | $316.23 | $346.74 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $549.54 Median $616.60 Typical High $660.69 | Professional | 63 · Small infant | $549.54 | $616.60 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $173.78 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $69.18 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $56.23 | $56.23 |
Where Idaho sits
The same service costs 7.3 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 $6,269MT $863
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.