How much rates vary
Facilitymedian $4,571 · 10th to 90th $832 to $12,882Professionalmedian $832 · 10th to 90th $525 to $1,413
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 $831.76 Median $1,698.24 Typical High $7,762.47 | Facility | None | $831.76 | $1,698.24 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,412.54 Typical High $1,412.54 | Professional | None | $467.74 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $416.87 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $83.18 | $213.80 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $17,378.01 | Facility | None | $2,754.23 | $5,011.87 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $954.99 | Professional | None | $758.58 | $891.25 | $954.99 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $794.33 | $831.76 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $93.33 |
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 $588.84 Median $691.83 Typical High $812.83 | Professional | None | $588.84 | $691.83 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,041.74 Typical High $8,317.64 | Facility | None | $645.65 | $2,041.74 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $912.01 Typical High $1,412.54 | Professional | None | $512.86 | $912.01 | $1,412.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $489.78 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $97.72 | $213.80 | $213.80 |
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 $676.08 Median $831.76 Typical High $831.76 | Facility | None | $676.08 | $831.76 | $831.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
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 $794.33 Median $954.99 Typical High $954.99 | Professional | None | $794.33 | $954.99 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $5,623.41 | Facility | None | $398.11 | $398.11 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $891.25 | Professional | None | $398.11 | $398.11 | $891.25 |
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 $524.81 Median $660.69 Typical High $1,023.29 | Professional | None | $524.81 | $660.69 | $1,023.29 |
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 $275.42 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $275.42 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $109.65 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $54.95 | $141.25 | $141.25 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 63 · Small infant | $912.01 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $616.60 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $323.59 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $131.83 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $64.57 | $141.25 | $141.25 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 22 · Increased work | $1,258.93 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 63 · Small infant | $1,258.93 | $1,258.93 | $1,258.93 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Where Idaho sits
The same service costs 5.9 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 $8,723MT $1,483
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.