How much rates vary
Facilitymedian $1,202 · 10th to 90th $437 to $3,981Professionalmedian $191 · 10th to 90th $126 to $339
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 $128.82 Median $338.84 Typical High $338.84 | Professional | None | $128.82 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $95.50 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $19.05 | $51.29 | $51.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $3,981.07 | Facility | None | $1,000.00 | $1,819.70 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | None | $169.82 | $199.53 | $234.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $151.36 | $173.78 | $208.93 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,445.44 | Facility | None | $933.25 | $1,047.13 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $186.21 | Professional | None | $128.82 | $162.18 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $338.84 Typical High $5,495.41 | Facility | None | $112.20 | $338.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $338.84 | Professional | None | $141.25 | $213.80 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $107.15 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $21.38 | $51.29 | $51.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $181.97 | Facility | None | $147.91 | $181.97 | $181.97 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | None | $181.97 | $181.97 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $162.18 | $162.18 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,801.89 | $5,011.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | None | $186.21 | $218.78 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $2,511.89 | Facility | None | $87.10 | $89.13 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $213.80 | Professional | None | $87.10 | $87.10 | $213.80 |
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 $102.33 Median $141.25 Typical High $199.53 | Professional | None | $102.33 | $141.25 | $199.53 |
12 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 $64.57 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $64.57 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $25.70 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.88 | $33.88 | $33.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $204.17 Median $234.42 Typical High $281.84 | Professional | 63 · Small infant | $204.17 | $234.42 | $281.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $70.79 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $28.18 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.13 | $33.88 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 22 · Increased work | $257.04 | $257.04 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 63 · Small infant | $257.04 | $257.04 | $257.04 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $173.78 |
Where Idaho sits
The same service costs 13.7 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 $4,510MT $328
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.