How much rates vary
Facilitymedian $2,512 · 10th to 90th $759 to $8,511Professionalmedian $316 · 10th to 90th $204 to $457
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $457.09 | Professional | None | $186.21 | $275.42 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $154.88 | $346.74 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $9,549.93 | Facility | None | $1,778.28 | $3,235.94 | $9,549.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $380.19 | Professional | None | $288.40 | $346.74 | $380.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $302.00 | $316.23 |
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 $234.42 Median $275.42 Typical High $323.59 | Professional | None | $234.42 | $275.42 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $660.69 Typical High $5,495.41 | Facility | None | $234.42 | $660.69 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $457.09 | Professional | None | $251.19 | $323.59 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $190.55 | $346.74 | $346.74 |
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 $316.23 Median $316.23 Typical High $3,235.94 | Facility | None | $316.23 | $316.23 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | None | $316.23 | $316.23 | $363.08 |
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 $316.23 Median $380.19 Typical High $389.05 | Professional | None | $316.23 | $380.19 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $6,760.83 | Facility | None | $151.36 | $154.88 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $239.88 | Professional | None | $151.36 | $151.36 | $239.88 |
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 $190.55 Median $275.42 Typical High $398.11 | Professional | None | $190.55 | $275.42 | $398.11 |
11 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 $102.33 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $102.33 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $41.69 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $30.90 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $20.89 | $45.71 | $45.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $35.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $338.84 Median $407.38 Typical High $426.58 | Professional | 63 · Small infant | $338.84 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $125.89 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $38.02 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $25.12 | $45.71 | $45.71 |
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 $6,301MT $557
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.