How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $4,467Professionalmedian $302 · 10th to 90th $200 to $437
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 $190.55 Median $436.52 Typical High $436.52 | Professional | None | $190.55 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $141.25 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $28.84 | $66.07 | $66.07 |
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 $281.84 Median $331.13 Typical High $338.84 | Professional | None | $281.84 | $331.13 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $33.88 |
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 $223.87 Median $263.03 Typical High $309.03 | Professional | None | $223.87 | $263.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $5,495.41 | Facility | None | $218.78 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $436.52 | Professional | None | $234.42 | $331.13 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $173.78 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $34.67 | $66.07 | $66.07 |
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 $245.47 Median $302.00 Typical High $302.00 | Facility | None | $245.47 | $302.00 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
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 $295.12 Median $331.13 Typical High $338.84 | Professional | None | $295.12 | $331.13 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $2,818.38 | Facility | None | $144.54 | $147.91 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $218.78 | Professional | None | $144.54 | $144.54 | $218.78 |
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 $173.78 Median $257.04 Typical High $371.54 | Professional | None | $173.78 | $257.04 | $371.54 |
8 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 $95.50 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $95.50 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $38.02 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.05 | $43.65 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $380.19 Typical High $407.38 | Professional | 63 · Small infant | $331.13 | $380.19 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $117.49 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $43.65 | $43.65 |
Where Idaho sits
The same service costs 9.2 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 $4,822MT $526
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.