How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,047 to $7,244Professionalmedian $759 · 10th to 90th $490 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 $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 $489.78 Median $1,047.13 Typical High $1,047.13 | Professional | None | $489.78 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $8,317.64 | Facility | None | $1,905.46 | $3,548.13 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $851.14 | Professional | None | $707.95 | $831.76 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Professional | None | $537.03 | $630.96 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $5,495.41 | Facility | None | $446.68 | $1,479.11 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,047.13 | Professional | None | $616.60 | $812.83 | $1,047.13 |
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 $630.96 Median $758.58 Typical High $758.58 | Facility | None | $630.96 | $758.58 | $758.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | None | $758.58 | $758.58 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $891.25 | Professional | None | $741.31 | $851.14 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $4,897.79 | Facility | None | $363.08 | $371.54 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | None | $363.08 | $363.08 | $537.03 |
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 $426.58 Median $660.69 Typical High $912.01 | Professional | None | $426.58 | $660.69 | $912.01 |
16 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 $239.88 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $239.88 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $97.72 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $363.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $72.44 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $48.98 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $338.84 | $724.44 | $724.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $707.95 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $85.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $831.76 Median $954.99 Typical High $1,023.29 | Professional | 63 · Small infant | $831.76 | $954.99 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $309.03 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $123.03 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $467.74 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $93.33 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $61.66 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $436.52 | $724.44 | $724.44 |
Where Idaho sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.