How much rates vary
Facilitymedian $1,202 · 10th to 90th $501 to $4,898Professionalmedian $363 · 10th to 90th $245 to $589
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 $245.47 Median $588.84 Typical High $588.84 | Professional | None | $245.47 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $186.21 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $37.15 | $87.10 | $87.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $4,897.79 | Facility | None | $933.25 | $1,318.26 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $389.05 | Professional | None | $323.59 | $380.19 | $389.05 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $288.40 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $38.90 |
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 $251.19 Median $309.03 Typical High $371.54 | Professional | None | $251.19 | $309.03 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $588.84 Typical High $5,495.41 | Facility | None | $269.15 | $588.84 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $588.84 | Professional | None | $269.15 | $380.19 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $204.17 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $40.74 | $87.10 | $87.10 |
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 $281.84 Median $346.74 Typical High $346.74 | Facility | None | $281.84 | $346.74 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | None | $346.74 | $346.74 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
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 $331.13 Median $389.05 Typical High $398.11 | Professional | None | $331.13 | $389.05 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $169.82 Typical High $3,715.35 | Facility | None | $165.96 | $169.82 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $371.54 | Professional | None | $165.96 | $165.96 | $371.54 |
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 $218.78 Median $316.23 Typical High $575.44 | Professional | None | $218.78 | $316.23 | $575.44 |
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 $123.03 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $123.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $48.98 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $24.55 | $58.88 | $58.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $234.42 Typical High $245.47 | Professional | 62 · Two surgeons | $199.53 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $446.68 Typical High $467.74 | Professional | 63 · Small infant | $389.05 | $446.68 | $467.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $134.90 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $53.70 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $26.92 | $58.88 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 22 · Increased work | $426.58 | $426.58 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 62 · Two surgeons | $239.88 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 63 · Small infant | $426.58 | $426.58 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $288.40 |
Where Idaho sits
The same service costs 6.8 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 $4,179MT $618
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.