How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $4,467Professionalmedian $380 · 10th to 90th $182 to $871
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $380.19 Typical High $1,148.15 | Professional | None | $147.91 | $380.19 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $281.84 Typical High $851.14 | Professional | 54 · Surgery only | $131.83 | $281.84 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $56.23 Typical High $173.78 | Professional | 55 · Aftercare only | $26.30 | $56.23 | $173.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $4,897.79 | Facility | None | $912.01 | $1,380.38 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $549.54 Typical High $870.96 | Professional | None | $218.78 | $549.54 | $870.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $190.55 | $660.69 | $776.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $83.18 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,513.56 | Facility | None | $977.24 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $602.56 | Professional | None | $181.97 | $288.40 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $537.03 Typical High $5,495.41 | Facility | None | $154.88 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $1,148.15 | Professional | None | $181.97 | $380.19 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $281.84 Typical High $851.14 | Professional | 54 · Surgery only | $131.83 | $281.84 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $56.23 Typical High $173.78 | Professional | 55 · Aftercare only | $26.30 | $56.23 | $173.78 |
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 $229.09 Median $229.09 Typical High $794.33 | Facility | None | $229.09 | $229.09 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $812.83 | Professional | None | $229.09 | $398.11 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $281.84 Typical High $524.81 | Professional | 54 · Surgery only | $177.83 | $281.84 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $6,165.95 | Facility | None | $2,754.23 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $776.25 | Professional | None | $245.47 | $323.59 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $3,311.31 | Facility | None | $380.19 | $389.05 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $380.19 Typical High $478.63 | Professional | None | $144.54 | $380.19 | $478.63 |
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 $141.25 Median $269.15 Typical High $562.34 | Professional | None | $141.25 | $269.15 | $562.34 |
10 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 $89.13 Median $190.55 Typical High $575.44 | Professional | 52 · Reduced service | $89.13 | $190.55 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $75.86 Typical High $229.09 | Professional | 53 · Discontinued | $35.48 | $75.86 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $38.02 Typical High $114.82 | Professional | 56 · Pre-op care only | $17.78 | $38.02 | $114.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $251.19 Median $870.96 Typical High $1,047.13 | Professional | 63 · Small infant | $251.19 | $870.96 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $190.55 Typical High $575.44 | Professional | 52 · Reduced service | $89.13 | $190.55 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $75.86 Typical High $229.09 | Professional | 53 · Discontinued | $35.48 | $75.86 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $38.02 Typical High $114.82 | Professional | 56 · Pre-op care only | $17.78 | $38.02 | $114.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $39.81 Typical High $74.13 | Professional | 56 · Pre-op care only | $25.12 | $39.81 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $562.34 |
Where Idaho sits
The same service costs 5.7 times more in Colorado 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
CO $4,090MT $722
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.