How much rates vary
Facilitymedian $1,202 · 10th to 90th $575 to $5,754Professionalmedian $646 · 10th to 90th $407 to $1,096
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 $645.65 Median $1,318.26 Typical High $7,762.47 | Facility | None | $645.65 | $1,318.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,096.48 Typical High $1,096.48 | Professional | None | $371.54 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $323.59 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $64.57 | $165.96 | $165.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $3,019.95 Typical High $6,025.60 | Facility | None | $1,202.26 | $3,019.95 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $741.31 | Professional | None | $602.56 | $707.95 | $741.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $616.60 | $660.69 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $72.44 |
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 $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $6,606.93 | Facility | None | $645.65 | $2,754.23 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $1,096.48 | Professional | None | $371.54 | $724.44 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $380.19 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $75.86 | $165.96 | $165.96 |
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 $524.81 Median $645.65 Typical High $645.65 | Facility | None | $524.81 | $645.65 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $7,413.10 | Facility | None | $3,630.78 | $5,754.40 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | None | $630.96 | $741.31 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $4,466.84 | Facility | None | $309.03 | $316.23 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $707.95 | Professional | None | $309.03 | $309.03 | $707.95 |
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 $407.38 Median $524.81 Typical High $812.83 | Professional | None | $407.38 | $524.81 | $812.83 |
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 $218.78 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $218.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $87.10 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $43.65 | $109.65 | $109.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $724.44 Median $831.76 Typical High $870.96 | Professional | 63 · Small infant | $724.44 | $831.76 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $257.04 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $102.33 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $51.29 | $109.65 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 22 · Increased work | $1,000.00 | $1,000.00 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 63 · Small infant | $1,000.00 | $1,000.00 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Idaho sits
The same service costs 5.0 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 $5,749MT $1,151
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.