How much rates vary
Facilitymedian $2,042 · 10th to 90th $676 to $7,244Professionalmedian $692 · 10th to 90th $457 to $1,047
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 $537.03 Median $851.14 Typical High $5,495.41 | Facility | None | $537.03 | $851.14 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,023.29 | Professional | None | $416.87 | $676.08 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $501.19 Typical High $758.58 | Professional | 54 · Surgery only | $309.03 | $501.19 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $288.40 | $467.74 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $8,511.38 | Facility | None | $2,041.74 | $3,019.95 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,071.52 | Professional | None | $562.34 | $758.58 | $1,071.52 |
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 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $724.44 |
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 $467.74 Median $1,023.29 Typical High $5,495.41 | Facility | None | $467.74 | $1,023.29 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,148.15 | Professional | None | $512.86 | $794.33 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $501.19 Typical High $758.58 | Professional | 54 · Surgery only | $309.03 | $501.19 | $758.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $288.40 | $467.74 | $707.95 |
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 $467.74 Median $478.63 Typical High $3,981.07 | Facility | None | $467.74 | $478.63 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $1,862.09 | Professional | None | $331.13 | $467.74 | $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 $954.99 | Professional | None | $354.81 | $537.03 | $954.99 |
13 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 $512.86 | Professional | 52 · Reduced service | $208.93 | $338.84 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $204.17 | Professional | 53 · Discontinued | $83.18 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $102.33 Typical High $151.36 | Professional | 55 · Aftercare only | $63.10 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $102.33 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $102.33 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $109.65 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $109.65 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $549.54 Typical High $691.83 | Professional | 62 · Two surgeons | $380.19 | $549.54 | $691.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $676.08 Median $831.76 Typical High $1,230.27 | Professional | 63 · Small infant | $676.08 | $831.76 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $338.84 Typical High $512.86 | Professional | 52 · Reduced service | $208.93 | $338.84 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $134.90 Typical High $204.17 | Professional | 53 · Discontinued | $83.18 | $134.90 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $102.33 Typical High $151.36 | Professional | 55 · Aftercare only | $63.10 | $102.33 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $67.61 Typical High $102.33 | Professional | 56 · Pre-op care only | $41.69 | $67.61 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $457.09 Typical High $691.83 | Professional | 62 · Two surgeons | $457.09 | $457.09 | $691.83 |
Where Idaho sits
The same service costs 6.4 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 $6,390WV $1,003
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.