How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,738 to $13,183Professionalmedian $1,950 · 10th to 90th $288 to $4,898
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $2,041.74 Typical High $6,309.57 | Professional | None | $223.87 | $2,041.74 | $6,309.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $7,585.78 Typical High $16,595.87 | Facility | None | $3,548.13 | $7,585.78 | $16,595.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $346.74 Median $3,311.31 Typical High $4,073.80 | Professional | None | $346.74 | $3,311.31 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $5,370.32 Typical High $7,244.36 | Facility | None | $4,786.30 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $3,801.89 | Professional | None | $302.00 | $457.09 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $3,388.44 Typical High $9,120.11 | Facility | None | $275.42 | $3,388.44 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $2,041.74 Typical High $6,309.57 | Professional | None | $295.12 | $2,041.74 | $6,309.57 |
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 $371.54 Median $371.54 Typical High $3,630.78 | Facility | None | $371.54 | $371.54 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $371.54 Median $3,630.78 Typical High $4,073.80 | Professional | None | $371.54 | $3,630.78 | $4,073.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $17,782.79 | Facility | None | $9,332.54 | $13,182.57 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $3,981.07 | Professional | None | $416.87 | $457.09 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $8,709.64 | Facility | None | $1,737.80 | $1,778.28 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $1,737.80 Typical High $2,398.83 | Professional | None | $234.42 | $1,737.80 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $263.03 Median $1,949.84 Typical High $5,011.87 | Professional | None | $263.03 | $1,949.84 | $5,011.87 |
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 $138.04 Median $338.84 Typical High $3,162.28 | Professional | 52 · Reduced service | $138.04 | $338.84 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $134.90 Typical High $1,288.25 | Professional | 53 · Discontinued | $54.95 | $134.90 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $501.19 Typical High $4,786.30 | Professional | 54 · Surgery only | $208.93 | $501.19 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $100.00 Typical High $954.99 | Professional | 55 · Aftercare only | $41.69 | $100.00 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $67.61 Typical High $630.96 | Professional | 56 · Pre-op care only | $27.54 | $67.61 | $630.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $2,951.21 Typical High $3,630.78 | Professional | 54 · Surgery only | $309.03 | $2,951.21 | $3,630.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $398.11 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $398.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $478.63 Median $3,715.35 Typical High $4,897.79 | Professional | 63 · Small infant | $478.63 | $3,715.35 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $239.88 | $2,691.53 | $2,884.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $338.84 Typical High $3,162.28 | Professional | 52 · Reduced service | $147.91 | $338.84 | $3,162.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $134.90 Typical High $1,288.25 | Professional | 53 · Discontinued | $58.88 | $134.90 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $501.19 Typical High $4,786.30 | Professional | 54 · Surgery only | $218.78 | $501.19 | $4,786.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $100.00 Typical High $954.99 | Professional | 55 · Aftercare only | $43.65 | $100.00 | $954.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $67.61 Typical High $630.96 | Professional | 56 · Pre-op care only | $29.51 | $67.61 | $630.96 |
Where Idaho sits
The same service costs 3.8 times more in Alaska 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
AK $12,117MT $3,226
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.