How much rates vary
Facilitymedian $1,122 · 10th to 90th $490 to $4,467Professionalmedian $490 · 10th to 90th $240 to $1,047
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 $194.98 Median $489.78 Typical High $1,348.96 | Professional | None | $194.98 | $489.78 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $371.54 Typical High $1,023.29 | Professional | 54 · Surgery only | $173.78 | $371.54 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $74.13 Typical High $204.17 | Professional | 55 · Aftercare only | $34.67 | $74.13 | $204.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $4,897.79 | Facility | None | $933.25 | $1,288.25 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $281.84 Median $660.69 Typical High $1,047.13 | Professional | None | $281.84 | $660.69 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $891.25 | Professional | 54 · Surgery only | $245.47 | $302.00 | $891.25 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $102.33 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $102.33 |
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 $239.88 Median $346.74 Typical High $724.44 | Professional | None | $239.88 | $346.74 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $707.95 Typical High $7,244.36 | Facility | None | $208.93 | $707.95 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $1,348.96 | Professional | None | $229.09 | $489.78 | $1,348.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $371.54 Typical High $1,023.29 | Professional | 54 · Surgery only | $173.78 | $371.54 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $74.13 Typical High $204.17 | Professional | 55 · Aftercare only | $34.67 | $74.13 | $204.17 |
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 $295.12 Median $295.12 Typical High $954.99 | Facility | None | $295.12 | $295.12 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $977.24 | Professional | None | $295.12 | $524.81 | $977.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $363.08 Typical High $602.56 | Professional | 54 · Surgery only | $229.09 | $363.08 | $602.56 |
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 $323.59 Median $426.58 Typical High $891.25 | Professional | None | $323.59 | $426.58 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $3,311.31 | Facility | None | $457.09 | $467.74 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $457.09 Typical High $549.54 | Professional | None | $186.21 | $457.09 | $549.54 |
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 $186.21 Median $346.74 Typical High $676.08 | Professional | None | $186.21 | $346.74 | $676.08 |
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 $114.82 Median $245.47 Typical High $676.08 | Professional | 52 · Reduced service | $114.82 | $245.47 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $100.00 Typical High $269.15 | Professional | 53 · Discontinued | $45.71 | $100.00 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $48.98 Typical High $134.90 | Professional | 56 · Pre-op care only | $22.91 | $48.98 | $134.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $338.84 Median $389.05 Typical High $1,230.27 | Professional | 63 · Small infant | $338.84 | $389.05 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $245.47 Typical High $676.08 | Professional | 52 · Reduced service | $114.82 | $245.47 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $100.00 Typical High $269.15 | Professional | 53 · Discontinued | $45.71 | $100.00 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $48.98 Typical High $134.90 | Professional | 56 · Pre-op care only | $22.91 | $48.98 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $87.10 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $87.10 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $645.65 |
Where Idaho sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.