How much rates vary
Facilitymedian $2,455 · 10th to 90th $501 to $8,511Professionalmedian $316 · 10th to 90th $204 to $537
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 $190.55 Median $537.03 Typical High $537.03 | Professional | None | $190.55 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $30.90 | $81.28 | $81.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $977.24 Median $2,754.23 Typical High $10,000.00 | Facility | None | $977.24 | $2,754.23 | $10,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | None | $288.40 | $338.84 | $371.54 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $295.12 | $323.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,311.31 | Facility | None | $2,187.76 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $309.03 | Professional | None | $229.09 | $263.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $537.03 Typical High $5,495.41 | Facility | None | $147.91 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $537.03 | Professional | None | $251.19 | $354.81 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $186.21 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $37.15 | $81.28 | $81.28 |
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 $251.19 Median $309.03 Typical High $309.03 | Facility | None | $251.19 | $309.03 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | None | $309.03 | $309.03 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $8,511.38 Typical High $12,589.25 | Facility | None | $5,128.61 | $8,511.38 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $346.74 | Professional | None | $147.91 | $147.91 | $346.74 |
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 $190.55 Median $251.19 Typical High $380.19 | Professional | None | $190.55 | $251.19 | $380.19 |
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 $104.71 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $104.71 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $41.69 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.89 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $346.74 Median $398.11 Typical High $436.52 | Professional | 63 · Small infant | $346.74 | $398.11 | $436.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $199.53 | $229.09 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $123.03 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $50.12 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $25.12 | $53.70 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 22 · Increased work | $398.11 | $398.11 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 63 · Small infant | $398.11 | $398.11 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $269.15 |
Where Idaho sits
The same service costs 9.8 times more in Alabama 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
AL $5,589MT $570
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.