How much rates vary
Facilitymedian $1,047 · 10th to 90th $372 to $4,365Professionalmedian $331 · 10th to 90th $178 to $631
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 $229.09 Median $478.63 Typical High $5,495.41 | Facility | None | $229.09 | $478.63 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $331.13 Typical High $630.96 | Professional | None | $144.54 | $331.13 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,659.59 Typical High $4,466.84 | Facility | None | $912.01 | $1,659.59 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $602.56 | Professional | None | $223.87 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,412.54 | Facility | None | $933.25 | $1,047.13 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $407.38 | Professional | None | $190.55 | $288.40 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $707.95 Typical High $4,466.84 | Facility | None | $229.09 | $707.95 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $630.96 | Professional | None | $177.83 | $331.13 | $630.96 |
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 $239.88 Median $239.88 Typical High $562.34 | Facility | None | $239.88 | $239.88 | $562.34 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $562.34 | Professional | None | $239.88 | $275.42 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $5,495.41 | Facility | None | $2,884.03 | $4,168.69 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $512.86 | Professional | None | $257.04 | $281.84 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $2,398.83 | Facility | None | $269.15 | $269.15 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $323.59 | Professional | None | $147.91 | $269.15 | $323.59 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $524.81 | Professional | None | $147.91 | $288.40 | $524.81 |
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 $89.13 Median $165.96 Typical High $316.23 | Professional | 52 · Reduced service | $89.13 | $165.96 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $66.07 Typical High $125.89 | Professional | 53 · Discontinued | $35.48 | $66.07 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $251.19 Typical High $478.63 | Professional | 54 · Surgery only | $134.90 | $251.19 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $50.12 Typical High $95.50 | Professional | 55 · Aftercare only | $26.92 | $50.12 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $33.11 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.78 | $33.11 | $63.10 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $549.54 | Professional | 54 · Surgery only | $199.53 | $234.42 | $549.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $60.26 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $60.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $602.56 Typical High $724.44 | Professional | 63 · Small infant | $275.42 | $602.56 | $724.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $331.13 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $154.88 | $331.13 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $165.96 Typical High $316.23 | Professional | 52 · Reduced service | $89.13 | $165.96 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $66.07 Typical High $125.89 | Professional | 53 · Discontinued | $35.48 | $66.07 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $251.19 Typical High $478.63 | Professional | 54 · Surgery only | $134.90 | $251.19 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $50.12 Typical High $95.50 | Professional | 55 · Aftercare only | $26.92 | $50.12 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $33.11 Typical High $63.10 | Professional | 56 · Pre-op care only | $17.78 | $33.11 | $63.10 |
Where Idaho sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.