How much rates vary
Facilitymedian $2,042 · 10th to 90th $759 to $7,244Professionalmedian $692 · 10th to 90th $457 to $1,023
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 $416.87 Median $676.08 Typical High $1,000.00 | Professional | None | $416.87 | $676.08 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $316.23 | $501.19 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $467.74 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $295.12 | $467.74 | $691.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $8,511.38 | Facility | None | $1,548.82 | $2,454.71 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,047.13 | Professional | None | $562.34 | $741.31 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $954.99 | Professional | 54 · Surgery only | $512.86 | $616.60 | $954.99 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $56.23 | $85.11 | $109.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $741.31 |
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 $426.58 Median $549.54 Typical High $776.25 | Professional | None | $426.58 | $549.54 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $954.99 Typical High $5,495.41 | Facility | None | $416.87 | $954.99 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,000.00 | Professional | None | $512.86 | $794.33 | $1,000.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $316.23 | $501.19 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $467.74 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $295.12 | $467.74 | $691.83 |
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 $616.60 Median $616.60 Typical High $977.24 | Facility | None | $616.60 | $616.60 | $977.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,230.27 | Professional | None | $616.60 | $776.25 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $512.86 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $812.83 |
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 $660.69 Median $794.33 Typical High $1,174.90 | Professional | None | $660.69 | $794.33 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $3,981.07 | Facility | None | $457.09 | $467.74 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $1,862.09 | Professional | None | $338.84 | $457.09 | $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 $354.81 Median $537.03 Typical High $933.25 | Professional | None | $354.81 | $537.03 | $933.25 |
8 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 $208.93 Median $338.84 Typical High $501.19 | Professional | 52 · Reduced service | $208.93 | $338.84 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $199.53 | Professional | 53 · Discontinued | $83.18 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $100.00 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $100.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $758.58 Median $891.25 Typical High $1,202.26 | Professional | 63 · Small infant | $758.58 | $891.25 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $338.84 Typical High $501.19 | Professional | 52 · Reduced service | $208.93 | $338.84 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $199.53 | Professional | 53 · Discontinued | $83.18 | $134.90 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $100.00 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $100.00 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $107.15 |
Where Idaho sits
The same service costs 5.3 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 $6,378MT $1,213
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.