How much rates vary
Facilitymedian $1,202 · 10th to 90th $537 to $4,898Professionalmedian $324 · 10th to 90th $209 to $537
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 $204.17 Median $537.03 Typical High $537.03 | Professional | None | $204.17 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $158.49 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $31.62 | $79.43 | $79.43 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $4,897.79 | Facility | None | $1,122.02 | $1,548.82 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $354.81 | Professional | None | $295.12 | $346.74 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $302.00 | $323.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $35.48 |
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 $223.87 Median $263.03 Typical High $309.03 | Professional | None | $223.87 | $263.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $537.03 Typical High $5,495.41 | Facility | None | $213.80 | $537.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $537.03 | Professional | None | $245.47 | $346.74 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $186.21 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $37.15 | $79.43 | $79.43 |
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 $257.04 Median $316.23 Typical High $316.23 | Facility | None | $257.04 | $316.23 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | None | $316.23 | $316.23 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,162.28 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | None | $302.00 | $354.81 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $3,311.31 | Facility | None | $151.36 | $154.88 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $338.84 | Professional | None | $151.36 | $151.36 | $338.84 |
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 $194.98 Median $257.04 Typical High $389.05 | Professional | None | $194.98 | $257.04 | $389.05 |
16 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 $107.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $107.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $42.66 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $21.38 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $354.81 Median $407.38 Typical High $426.58 | Professional | 63 · Small infant | $354.81 | $407.38 | $426.58 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $204.17 | $234.42 | $251.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 80 · Assistant surgeon | $46.77 | $53.70 | $57.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $46.77 | $53.70 | $57.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $53.70 | $57.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $45.71 Typical High $47.86 | Professional | AS · PA/NP assist | $39.81 | $45.71 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $123.03 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $48.98 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $24.55 | $53.70 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 22 · Increased work | $389.05 | $389.05 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 63 · Small infant | $389.05 | $389.05 | $389.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $263.03 |
Where Idaho sits
The same service costs 7.3 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 $4,136MT $564
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.