How much rates vary
Facilitymedian $1,380 · 10th to 90th $457 to $6,166Professionalmedian $275 · 10th to 90th $178 to $457
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 $173.78 Median $457.09 Typical High $457.09 | Professional | None | $173.78 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $131.83 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $26.30 | $67.61 | $67.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,479.11 Median $3,019.95 Typical High $6,165.95 | Facility | None | $1,479.11 | $3,019.95 | $6,165.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | None | $245.47 | $288.40 | $302.00 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $218.78 | $251.19 | $269.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $29.51 |
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 $194.98 Median $223.87 Typical High $257.04 | Professional | None | $194.98 | $223.87 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $457.09 Typical High $5,495.41 | Facility | None | $125.89 | $457.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $457.09 | Professional | None | $208.93 | $295.12 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $154.88 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $30.90 | $67.61 | $67.61 |
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 $213.80 Median $263.03 Typical High $263.03 | Facility | None | $213.80 | $263.03 | $263.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | None | $263.03 | $263.03 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
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 $257.04 Median $302.00 Typical High $302.00 | Professional | None | $257.04 | $302.00 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $9,772.37 | Facility | None | $125.89 | $128.82 | $9,772.37 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $288.40 | Professional | None | $125.89 | $125.89 | $288.40 |
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 $169.82 Median $218.78 Typical High $331.13 | Professional | None | $169.82 | $218.78 | $331.13 |
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 $87.10 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $87.10 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $34.67 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $17.38 | $45.71 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $295.12 Median $338.84 Typical High $354.81 | Professional | 63 · Small infant | $295.12 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $169.82 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $104.71 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $41.69 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $20.89 | $45.71 | $45.71 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 22 · Increased work | $323.59 | $323.59 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 63 · Small infant | $323.59 | $323.59 | $323.59 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $223.87 |
Where Idaho sits
The same service costs 11.1 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 $5,221MT $469
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.