How much rates vary
Facilitymedian $1,288 · 10th to 90th $550 to $4,898Professionalmedian $575 · 10th to 90th $269 to $1,148
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 $676.08 Median $1,621.81 Typical High $5,495.41 | Facility | None | $676.08 | $1,621.81 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $575.44 Typical High $1,479.11 | Professional | None | $218.78 | $575.44 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $426.58 Typical High $1,122.02 | Professional | 54 · Surgery only | $199.53 | $426.58 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $87.10 Typical High $223.87 | Professional | 55 · Aftercare only | $39.81 | $87.10 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $4,466.84 | Facility | None | $933.25 | $1,737.80 | $4,466.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $758.58 Typical High $1,148.15 | Professional | None | $331.13 | $758.58 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $1,047.13 | Professional | 54 · Surgery only | $295.12 | $338.84 | $1,047.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.02 Typical High $114.82 | Professional | 55 · Aftercare only | $31.62 | $38.02 | $114.82 |
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 $275.42 Median $380.19 Typical High $794.33 | Professional | None | $275.42 | $380.19 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $5,495.41 | Facility | None | $501.19 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,479.11 | Professional | None | $263.03 | $575.44 | $1,479.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $426.58 Typical High $1,122.02 | Professional | 54 · Surgery only | $199.53 | $426.58 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $87.10 Typical High $223.87 | Professional | 55 · Aftercare only | $39.81 | $87.10 | $223.87 |
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 $338.84 Median $1,047.13 Typical High $1,737.80 | Facility | None | $338.84 | $1,047.13 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,071.52 | Professional | None | $338.84 | $602.56 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $676.08 | Professional | 54 · Surgery only | $269.15 | $426.58 | $676.08 |
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 $371.54 Median $489.78 Typical High $977.24 | Professional | None | $371.54 | $489.78 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $2,398.83 | Facility | None | $501.19 | $512.86 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $501.19 Typical High $602.56 | Professional | None | $213.80 | $501.19 | $602.56 |
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 $213.80 Median $389.05 Typical High $741.31 | Professional | None | $213.80 | $389.05 | $741.31 |
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 $131.83 Median $288.40 Typical High $741.31 | Professional | 52 · Reduced service | $131.83 | $288.40 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $114.82 Typical High $295.12 | Professional | 53 · Discontinued | $53.70 | $114.82 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $57.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $26.30 | $57.54 | $147.91 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $457.09 Typical High $1,348.96 | Professional | 63 · Small infant | $389.05 | $457.09 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $245.47 | $676.08 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $288.40 Typical High $741.31 | Professional | 52 · Reduced service | $131.83 | $288.40 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $114.82 Typical High $295.12 | Professional | 53 · Discontinued | $53.70 | $114.82 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $57.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $26.30 | $57.54 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $60.26 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.02 | $60.26 | $95.50 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $457.09 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $288.40 | $457.09 | $724.44 |
Where Idaho sits
The same service costs 4.1 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 $4,142MT $1,002
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.