How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $5,129Professionalmedian $389 · 10th to 90th $234 to $692
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 $194.98 Median $436.52 Typical High $724.44 | Professional | None | $194.98 | $436.52 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $549.54 | Professional | 54 · Surgery only | $173.78 | $323.59 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $4,466.84 | Facility | None | $912.01 | $1,905.46 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $691.83 | Professional | None | $288.40 | $478.63 | $691.83 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $436.52 Typical High $645.65 | Professional | 54 · Surgery only | $263.03 | $436.52 | $645.65 |
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 $245.47 Median $323.59 Typical High $467.74 | Professional | None | $245.47 | $323.59 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,621.81 Typical High $7,585.78 | Facility | None | $245.47 | $1,621.81 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $724.44 | Professional | None | $257.04 | $436.52 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $549.54 | Professional | 54 · Surgery only | $173.78 | $323.59 | $549.54 |
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 $630.96 | Facility | None | $316.23 | $316.23 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $630.96 | Professional | None | $316.23 | $354.81 | $630.96 |
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 $331.13 Median $363.08 Typical High $588.84 | Professional | None | $331.13 | $363.08 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $2,818.38 | Facility | None | $302.00 | $309.03 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $371.54 | Professional | None | $194.98 | $302.00 | $371.54 |
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 $190.55 Median $346.74 Typical High $602.56 | Professional | None | $190.55 | $346.74 | $602.56 |
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 $117.49 Median $213.80 Typical High $363.08 | Professional | 52 · Reduced service | $117.49 | $213.80 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $87.10 Typical High $144.54 | Professional | 53 · Discontinued | $46.77 | $87.10 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $109.65 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $43.65 Typical High $72.44 | Professional | 56 · Pre-op care only | $23.44 | $43.65 | $72.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $58.88 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $58.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $346.74 Median $407.38 Typical High $851.14 | Professional | 63 · Small infant | $346.74 | $407.38 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $239.88 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $204.17 | $239.88 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $213.80 Typical High $363.08 | Professional | 52 · Reduced service | $117.49 | $213.80 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $87.10 Typical High $144.54 | Professional | 53 · Discontinued | $46.77 | $87.10 | $144.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $64.57 Typical High $109.65 | Professional | 55 · Aftercare only | $35.48 | $64.57 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $43.65 Typical High $72.44 | Professional | 56 · Pre-op care only | $23.44 | $43.65 | $72.44 |
Where Idaho sits
The same service costs 7.0 times more in Vermont than in North Dakota. 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
VT $4,790ND $687
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.