How much rates vary
Facilitymedian $1,202 · 10th to 90th $437 to $3,981Professionalmedian $178 · 10th to 90th $117 to $331
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 $100.00 Median $331.13 Typical High $331.13 | Professional | None | $100.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $91.20 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $18.20 | $50.12 | $50.12 |
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 $158.49 Median $186.21 Typical High $223.87 | Professional | None | $158.49 | $186.21 | $223.87 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $144.54 | $165.96 | $199.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $22.39 |
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 $158.49 Typical High $186.21 | Professional | None | $128.82 | $158.49 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $331.13 Typical High $5,495.41 | Facility | None | $112.20 | $331.13 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $331.13 | Professional | None | $138.04 | $208.93 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $104.71 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $20.89 | $50.12 | $50.12 |
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 $141.25 Median $173.78 Typical High $173.78 | Facility | None | $141.25 | $173.78 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | None | $173.78 | $173.78 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
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 $177.83 Median $208.93 Typical High $208.93 | Professional | None | $177.83 | $208.93 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $2,951.21 | Facility | None | $83.18 | $83.18 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $204.17 | Professional | None | $83.18 | $83.18 | $204.17 |
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 $61.66 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $61.66 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $24.55 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.30 | $33.11 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $190.55 Median $218.78 Typical High $269.15 | Professional | 63 · Small infant | $190.55 | $218.78 | $269.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $69.18 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $27.54 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.80 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 22 · Increased work | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 63 · Small infant | $245.47 | $245.47 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 14.5 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 $4,506MT $310
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.