How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,692 to $25,704Professionalmedian $4,074 · 10th to 90th $562 to $9,333
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 $1,380.38 Median $4,466.84 Typical High $15,488.17 | Facility | None | $1,380.38 | $4,466.84 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $4,265.80 Typical High $14,791.08 | Professional | None | $436.52 | $4,265.80 | $14,791.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,709.64 Median $12,302.69 Typical High $33,113.11 | Facility | None | $8,709.64 | $12,302.69 | $33,113.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $7,244.36 Typical High $9,549.93 | Professional | None | $676.08 | $7,244.36 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $8,511.38 Typical High $11,481.54 | Facility | None | $7,585.78 | $8,511.38 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $8,128.31 | Professional | None | $588.84 | $870.96 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $5,495.41 Typical High $15,848.93 | Facility | None | $1,318.26 | $5,495.41 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $1,380.38 Typical High $14,791.08 | Professional | None | $562.34 | $1,380.38 | $14,791.08 |
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 $724.44 Median $724.44 Typical High $8,511.38 | Facility | None | $724.44 | $724.44 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724.44 Median $8,511.38 Typical High $9,332.54 | Professional | None | $724.44 | $8,511.38 | $9,332.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,498.45 Median $27,542.29 Typical High $36,307.81 | Facility | None | $19,498.45 | $27,542.29 | $36,307.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $9,120.11 | Professional | None | $812.83 | $891.25 | $9,120.11 |
Select Health Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $25,118.86 | Facility | None | $4,073.80 | $4,168.69 | $25,118.86 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $4,073.80 Typical High $5,370.32 | Professional | None | $457.09 | $4,073.80 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $478.63 Median $4,073.80 Typical High $8,709.64 | Professional | None | $478.63 | $4,073.80 | $8,709.64 |
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 $269.15 Median $645.65 Typical High $7,244.36 | Professional | 52 · Reduced service | $269.15 | $645.65 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $263.03 Typical High $2,951.21 | Professional | 53 · Discontinued | $107.15 | $263.03 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $977.24 Typical High $10,964.78 | Professional | 54 · Surgery only | $407.38 | $977.24 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $194.98 Typical High $2,187.76 | Professional | 55 · Aftercare only | $81.28 | $194.98 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $131.83 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $53.70 | $131.83 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $776.25 Typical High $8,317.64 | Professional | 54 · Surgery only | $602.56 | $776.25 | $8,317.64 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $933.25 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $933.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $1,023.29 Typical High $11,481.54 | Professional | 63 · Small infant | $776.25 | $1,023.29 | $11,481.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $602.56 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $478.63 | $602.56 | $6,456.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $645.65 Typical High $7,244.36 | Professional | 52 · Reduced service | $281.84 | $645.65 | $7,244.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $263.03 Typical High $2,951.21 | Professional | 53 · Discontinued | $112.20 | $263.03 | $2,951.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $977.24 Typical High $10,964.78 | Professional | 54 · Surgery only | $426.58 | $977.24 | $10,964.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $194.98 Typical High $2,187.76 | Professional | 55 · Aftercare only | $85.11 | $194.98 | $2,187.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $131.83 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $56.23 | $131.83 | $1,479.11 |
Where Idaho sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.