How much rates vary
Facilitymedian $1,000 · 10th to 90th $537 to $4,266Professionalmedian $550 · 10th to 90th $363 to $794
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 $645.65 Median $933.25 Typical High $5,495.41 | Facility | None | $645.65 | $933.25 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $794.33 | Professional | None | $331.13 | $537.03 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $251.19 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $380.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $234.42 | $380.19 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,905.46 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $812.83 | Professional | None | $446.68 | $588.84 | $812.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $407.38 | $478.63 | $758.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $616.60 | Professional | None | $346.74 | $436.52 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $794.33 Typical High $7,244.36 | Facility | None | $354.81 | $794.33 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $794.33 | Professional | None | $407.38 | $630.96 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $407.38 Typical High $588.84 | Professional | 54 · Surgery only | $251.19 | $407.38 | $588.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $380.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $234.42 | $380.19 | $549.54 |
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 $489.78 Median $489.78 Typical High $741.31 | Facility | None | $489.78 | $489.78 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $933.25 | Professional | None | $489.78 | $616.60 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $602.56 | Professional | 54 · Surgery only | $416.87 | $416.87 | $602.56 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $933.25 | Professional | None | $524.81 | $630.96 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $2,818.38 | Facility | None | $354.81 | $363.08 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $831.76 | Professional | None | $269.15 | $354.81 | $831.76 |
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 $288.40 Median $436.52 Typical High $758.58 | Professional | None | $288.40 | $436.52 | $758.58 |
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 $165.96 Median $269.15 Typical High $398.11 | Professional | 52 · Reduced service | $165.96 | $269.15 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $107.15 Typical High $158.49 | Professional | 53 · Discontinued | $66.07 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $81.28 Typical High $117.49 | Professional | 55 · Aftercare only | $50.12 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $53.70 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.11 | $53.70 | $79.43 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,479.11 Median $2,818.38 Typical High $6,309.57 | Facility | 50 · Both sides | $1,479.11 | $2,818.38 | $6,309.57 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $812.83 Typical High $1,230.27 | Professional | 50 · Both sides | $691.83 | $812.83 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $79.43 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $537.03 Median $812.83 Typical High $977.24 | Professional | 63 · Small infant | $537.03 | $812.83 | $977.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $269.15 Typical High $398.11 | Professional | 52 · Reduced service | $165.96 | $269.15 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $107.15 Typical High $158.49 | Professional | 53 · Discontinued | $66.07 | $107.15 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $81.28 Typical High $117.49 | Professional | 55 · Aftercare only | $50.12 | $81.28 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $53.70 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.11 | $53.70 | $79.43 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $891.25 | $891.25 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $85.11 |
Where Idaho sits
The same service costs 4.9 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 $4,754MT $976
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.