How much rates vary
Facilitymedian $1,698 · 10th to 90th $288 to $6,457Professionalmedian $257 · 10th to 90th $107 to $513
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 $309.03 Median $794.33 Typical High $5,495.41 | Facility | None | $309.03 | $794.33 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $660.69 | Professional | None | $107.15 | $257.04 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $870.96 Median $2,238.72 Typical High $8,317.64 | Facility | None | $870.96 | $2,238.72 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $141.25 Median $416.87 Typical High $512.86 | Professional | None | $141.25 | $416.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,778.28 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $363.08 | Professional | None | $120.23 | $245.47 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $389.05 Typical High $2,570.40 | Facility | None | $147.91 | $389.05 | $2,570.40 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $660.69 | Professional | None | $83.18 | $257.04 | $660.69 |
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 $151.36 Median $151.36 Typical High $457.09 | Facility | None | $151.36 | $151.36 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $151.36 Median $446.68 Typical High $467.74 | Professional | None | $151.36 | $446.68 | $467.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,495.41 | $7,943.28 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $426.58 | Professional | None | $162.18 | $177.83 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $223.87 Typical High $2,089.30 | Facility | None | $218.78 | $223.87 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $263.03 | Professional | None | $95.50 | $218.78 | $263.03 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $446.68 | Professional | None | $104.71 | $229.09 | $446.68 |
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 $52.48 Median $128.82 Typical High $331.13 | Professional | 52 · Reduced service | $52.48 | $128.82 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $52.48 Typical High $131.83 | Professional | 53 · Discontinued | $21.38 | $52.48 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $194.98 Typical High $501.19 | Professional | 54 · Surgery only | $79.43 | $194.98 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $38.90 Typical High $100.00 | Professional | 55 · Aftercare only | $15.85 | $38.90 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $25.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $10.47 | $25.70 | $66.07 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $141.25 | $380.19 | $467.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $14.13 | $42.66 | $50.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $169.82 Median $501.19 Typical High $616.60 | Professional | 63 · Small infant | $169.82 | $501.19 | $616.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $95.50 | $288.40 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $128.82 Typical High $331.13 | Professional | 52 · Reduced service | $56.23 | $128.82 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $52.48 Typical High $131.83 | Professional | 53 · Discontinued | $22.39 | $52.48 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $194.98 Typical High $501.19 | Professional | 54 · Surgery only | $83.18 | $194.98 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $38.90 Typical High $100.00 | Professional | 55 · Aftercare only | $16.98 | $38.90 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $25.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $11.22 | $25.70 | $66.07 |
Where Idaho sits
The same service costs 10.4 times more in Colorado 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
CO $4,594ND $443
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.