How much rates vary
Facilitymedian $2,239 · 10th to 90th $759 to $8,511Professionalmedian $417 · 10th to 90th $269 to $603
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 $380.19 Median $4,466.84 Typical High $7,244.36 | Facility | None | $380.19 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $602.56 | Professional | None | $251.19 | $363.08 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $204.17 | $457.09 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,041.74 Median $3,981.07 Typical High $9,772.37 | Facility | None | $2,041.74 | $3,981.07 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $489.78 | Professional | None | $380.19 | $446.68 | $489.78 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $398.11 | $416.87 |
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 $309.03 Median $363.08 Typical High $416.87 | Professional | None | $309.03 | $363.08 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $870.96 Typical High $7,943.28 | Facility | None | $316.23 | $870.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $602.56 | Professional | None | $331.13 | $426.58 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $245.47 | $457.09 | $457.09 |
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 $338.84 Median $416.87 Typical High $416.87 | Facility | None | $338.84 | $416.87 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | None | $416.87 | $416.87 | $478.63 |
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 $416.87 Median $489.78 Typical High $512.86 | Professional | None | $416.87 | $489.78 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $6,760.83 | Facility | None | $194.98 | $199.53 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | None | $194.98 | $194.98 | $316.23 |
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 $251.19 Median $363.08 Typical High $524.81 | Professional | None | $251.19 | $363.08 | $524.81 |
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 $138.04 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $138.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $54.95 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $40.74 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $27.54 | $60.26 | $60.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $46.77 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | 63 · Small infant | $446.68 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $165.96 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $66.07 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $50.12 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $33.11 | $60.26 | $60.26 |
Where Idaho sits
The same service costs 8.5 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 $6,252MT $735
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.