How much rates vary
Facilitymedian $4,571 · 10th to 90th $794 to $14,791Professionalmedian $794 · 10th to 90th $501 to $1,349
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 $724.44 Median $1,621.81 Typical High $7,762.47 | Facility | None | $724.44 | $1,621.81 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $1,348.96 Typical High $1,348.96 | Professional | None | $446.68 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $398.11 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $79.43 | $204.17 | $204.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $14,791.08 | Facility | None | $2,691.53 | $5,011.87 | $14,791.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $912.01 | Professional | None | $724.44 | $870.96 | $912.01 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $5,495.41 Typical High $14,791.08 | Facility | None | $724.44 | $5,495.41 | $14,791.08 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $1,348.96 | Professional | None | $457.09 | $891.25 | $1,348.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $467.74 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $93.33 | $204.17 | $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 $645.65 Median $794.33 Typical High $794.33 | Facility | None | $645.65 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,096.48 | Professional | None | $794.33 | $794.33 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $13,803.84 Typical High $18,620.87 | Facility | None | $9,772.37 | $13,803.84 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | None | $776.25 | $912.01 | $912.01 |
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 $380.19 Median $380.19 Typical High $870.96 | Professional | None | $380.19 | $380.19 | $870.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,000.00 | Professional | None | $501.19 | $645.65 | $1,000.00 |
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 $263.03 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $263.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $107.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $53.70 | $134.90 | $134.90 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $870.96 Median $1,023.29 Typical High $1,071.52 | Professional | 63 · Small infant | $870.96 | $1,023.29 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $316.23 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $125.89 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $63.10 | $134.90 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 22 · Increased work | $1,230.27 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 63 · Small infant | $1,230.27 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Idaho sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.