How much rates vary
Facilitymedian $1,862 · 10th to 90th $759 to $7,244Professionalmedian $813 · 10th to 90th $562 to $1,175
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 $616.60 Median $1,174.90 Typical High $1,621.81 | Professional | None | $616.60 | $1,174.90 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $831.76 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $562.34 | $831.76 | $1,148.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,778.28 Median $3,162.28 Typical High $8,317.64 | Facility | None | $1,778.28 | $3,162.28 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,202.26 | Professional | None | $676.08 | $831.76 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,621.81 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $870.96 | Professional | None | $501.19 | $630.96 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,174.90 Typical High $5,495.41 | Facility | None | $407.38 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,621.81 | Professional | None | $602.56 | $1,023.29 | $1,621.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $831.76 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $602.56 | $831.76 | $1,148.15 |
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 $707.95 Median $707.95 Typical High $1,096.48 | Facility | None | $707.95 | $707.95 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,096.48 | Professional | None | $707.95 | $794.33 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,585.78 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,122.02 | Professional | None | $776.25 | $831.76 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $4,897.79 | Facility | None | $524.81 | $537.03 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $933.25 | Professional | None | $436.52 | $616.60 | $933.25 |
15 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 $398.11 Median $588.84 Typical High $812.83 | Professional | 52 · Reduced service | $398.11 | $588.84 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $234.42 Typical High $323.59 | Professional | 53 · Discontinued | $158.49 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $891.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $602.56 | $891.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $177.83 Typical High $245.47 | Professional | 55 · Aftercare only | $120.23 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $79.43 | $117.49 | $162.18 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $676.08 | $912.01 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $109.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $891.25 Median $954.99 Typical High $1,479.11 | Professional | 63 · Small infant | $891.25 | $954.99 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $588.84 Typical High $812.83 | Professional | 52 · Reduced service | $436.52 | $588.84 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $234.42 Typical High $323.59 | Professional | 53 · Discontinued | $173.78 | $234.42 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $891.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $645.65 | $891.25 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $177.83 Typical High $245.47 | Professional | 55 · Aftercare only | $128.82 | $177.83 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $117.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $87.10 | $117.49 | $162.18 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $562.34 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $109.65 |
Where Idaho sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,614MT $1,440
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.