How much rates vary
Facilitymedian $1,549 · 10th to 90th $759 to $4,467Professionalmedian $646 · 10th to 90th $427 to $977
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 $758.58 Median $1,122.02 Typical High $5,495.41 | Facility | None | $758.58 | $1,122.02 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $954.99 | Professional | None | $389.05 | $630.96 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $295.12 | $478.63 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $275.42 | $446.68 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $4,466.84 | Facility | None | $1,621.81 | $1,949.84 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,000.00 | Professional | None | $537.03 | $707.95 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $478.63 | $588.84 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $724.44 |
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 $407.38 Median $524.81 Typical High $741.31 | Professional | None | $407.38 | $524.81 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $7,585.78 | Facility | None | $389.05 | $954.99 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | None | $478.63 | $741.31 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $295.12 | $478.63 | $707.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $275.42 | $446.68 | $660.69 |
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 $575.44 Median $912.01 Typical High $1,698.24 | Facility | None | $575.44 | $912.01 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,148.15 | Professional | None | $575.44 | $724.44 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $489.78 | $724.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $4,073.80 Typical High $5,248.07 | Facility | None | $2,691.53 | $4,073.80 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,122.02 | Professional | None | $630.96 | $741.31 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $3,630.78 | Facility | None | $436.52 | $446.68 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $977.24 | Professional | None | $316.23 | $436.52 | $977.24 |
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 $338.84 Median $512.86 Typical High $912.01 | Professional | None | $338.84 | $512.86 | $912.01 |
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 $194.98 Median $316.23 Typical High $478.63 | Professional | 52 · Reduced service | $194.98 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $77.62 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $95.50 Typical High $141.25 | Professional | 55 · Aftercare only | $58.88 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $63.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.90 | $63.10 | $95.50 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,570.40 Median $3,019.95 Typical High $7,244.36 | Facility | 50 · Both sides | $2,570.40 | $3,019.95 | $7,244.36 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,047.13 Typical High $1,479.11 | Professional | 50 · Both sides | $794.33 | $1,047.13 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $102.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $1,023.29 Typical High $1,230.27 | Professional | 63 · Small infant | $645.65 | $1,023.29 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $316.23 Typical High $478.63 | Professional | 52 · Reduced service | $194.98 | $316.23 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $77.62 | $125.89 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $95.50 Typical High $141.25 | Professional | 55 · Aftercare only | $58.88 | $95.50 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $63.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.90 | $63.10 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,047.13 Typical High $1,548.82 | Professional | 50 · Both sides | $1,047.13 | $1,047.13 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $102.33 |
Where Idaho sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.