How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $7,943Professionalmedian $295 · 10th to 90th $200 to $437
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 $275.42 Median $524.81 Typical High $7,762.47 | Facility | None | $275.42 | $524.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $501.19 | Professional | None | $181.97 | $436.52 | $501.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $9,772.37 | Facility | None | $2,290.87 | $3,235.94 | $9,772.37 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,467.37 Median $4,897.79 Typical High $14,791.08 | Facility | 50 · Both sides | $3,467.37 | $4,897.79 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $354.81 | Professional | None | $275.42 | $323.59 | $354.81 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $489.78 Typical High $501.19 | Professional | 50 · Both sides | $398.11 | $489.78 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,862.09 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $302.00 | Professional | None | $223.87 | $263.03 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $524.81 Typical High $5,495.41 | Facility | None | $239.88 | $524.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $489.78 | Professional | None | $199.53 | $302.00 | $489.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $3,235.94 | Facility | None | $295.12 | $295.12 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $12,302.69 | Facility | None | $6,025.60 | $8,511.38 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $371.54 | Professional | None | $323.59 | $354.81 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $4,365.16 | Facility | None | $141.25 | $144.54 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | None | $141.25 | $141.25 | $229.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,187.76 | Facility | None | $1,047.13 | $1,412.54 | $2,187.76 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $398.11 | Professional | None | $194.98 | $281.84 | $398.11 |
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 $104.71 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $104.71 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $41.69 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $158.49 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $31.62 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $20.89 | $43.65 | $43.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $239.88 | $288.40 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $33.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 63 · Small infant | $323.59 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $120.23 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $47.86 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $181.97 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $36.31 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.99 | $43.65 | $43.65 |
Where Idaho sits
The same service costs 11.3 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 $6,151MT $545
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.