How much rates vary
Facilitymedian $891 · 10th to 90th $501 to $3,090Professionalmedian $309 · 10th to 90th $204 to $501
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $501.19 Typical High $501.19 | Professional | None | $204.17 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $169.82 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $33.88 | $74.13 | $74.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $3,090.30 | Facility | None | $776.25 | $1,288.25 | $3,090.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | None | $275.42 | $323.59 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $245.47 | $288.40 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $33.11 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $295.12 | Professional | None | $213.80 | $257.04 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $501.19 Typical High $5,495.41 | Facility | None | $229.09 | $501.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $501.19 | Professional | None | $229.09 | $323.59 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $173.78 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $34.67 | $74.13 | $74.13 |
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 $239.88 Median $295.12 Typical High $295.12 | Facility | None | $239.88 | $295.12 | $295.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | None | $295.12 | $295.12 | $331.13 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $229.09 | $229.09 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Facility | None | $1,995.26 | $2,630.27 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | None | $288.40 | $338.84 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $2,344.23 | Facility | None | $141.25 | $144.54 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $316.23 | Professional | None | $141.25 | $141.25 | $316.23 |
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 $186.21 Median $263.03 Typical High $467.74 | Professional | None | $186.21 | $263.03 | $467.74 |
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 $112.20 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $112.20 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $45.71 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $22.39 | $50.12 | $50.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 63 · Small infant | $331.13 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $114.82 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $45.71 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $22.91 | $50.12 | $50.12 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 22 · Increased work | $363.08 | $363.08 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 63 · Small infant | $363.08 | $363.08 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $245.47 |
Where Idaho sits
The same service costs 7.7 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 $4,047MT $526
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.