How much rates vary
Facilitymedian $4,074 · 10th to 90th $759 to $14,454Professionalmedian $759 · 10th to 90th $501 to $1,175
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,122.02 | Professional | None | $457.09 | $741.31 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $323.59 | $524.81 | $776.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $18,620.87 | Facility | None | $1,621.81 | $4,897.79 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,202.26 | Professional | None | $630.96 | $831.76 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $870.96 | Professional | None | $467.74 | $616.60 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $5,495.41 | Facility | None | $436.52 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,122.02 | Professional | None | $575.44 | $870.96 | $1,122.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $323.59 | $524.81 | $776.25 |
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 $676.08 Median $676.08 Typical High $1,096.48 | Facility | None | $676.08 | $676.08 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,380.38 | Professional | None | $676.08 | $870.96 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $912.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,288.25 | Professional | None | $741.31 | $870.96 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $3,981.07 | Facility | None | $524.81 | $537.03 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $4,168.69 | Professional | None | $371.54 | $524.81 | $4,168.69 |
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 $389.05 Median $602.56 Typical High $1,000.00 | Professional | None | $389.05 | $602.56 | $1,000.00 |
20 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 $229.09 Median $371.54 Typical High $562.34 | Professional | 52 · Reduced service | $229.09 | $371.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | 53 · Discontinued | $91.20 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $346.74 | $562.34 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $112.20 Typical High $165.96 | Professional | 55 · Aftercare only | $69.18 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $74.13 | $112.20 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,398.83 Median $7,413.10 Typical High $28,183.83 | Facility | 50 · Both sides | $2,398.83 | $7,413.10 | $28,183.83 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,862.09 | Professional | 50 · Both sides | $954.99 | $1,230.27 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $588.84 | $851.14 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $64.57 | $102.33 | $120.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $724.44 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $724.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | 63 · Small infant | $758.58 | $891.25 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $371.54 Typical High $562.34 | Professional | 52 · Reduced service | $229.09 | $371.54 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | 53 · Discontinued | $91.20 | $147.91 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $346.74 | $562.34 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $112.20 Typical High $165.96 | Professional | 55 · Aftercare only | $69.18 | $112.20 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $74.13 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,230.27 Typical High $1,819.70 | Professional | 50 · Both sides | $1,230.27 | $1,230.27 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | 54 · Surgery only | $575.44 | $575.44 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $120.23 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | 62 · Two surgeons | $512.86 | $512.86 | $758.58 |
Where Idaho sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.