How much rates vary
Facilitymedian $589 · 10th to 90th $282 to $3,090Professionalmedian $219 · 10th to 90th $105 to $646
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 $257.04 Median $1,000.00 Typical High $5,495.41 | Facility | None | $257.04 | $1,000.00 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $831.76 | Professional | None | $81.28 | $218.78 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $162.18 Typical High $630.96 | Professional | 54 · Surgery only | $77.62 | $162.18 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $32.36 Typical High $125.89 | Professional | 55 · Aftercare only | $15.49 | $32.36 | $125.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $302.00 Median $812.83 Typical High $3,090.30 | Facility | None | $302.00 | $812.83 | $3,090.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $131.83 Median $407.38 Typical High $645.65 | Professional | None | $131.83 | $407.38 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $117.49 | $467.74 | $575.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $12.59 | $53.70 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $323.59 Typical High $436.52 | Facility | None | $288.40 | $323.59 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $446.68 | Professional | None | $104.71 | $194.98 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $436.52 Typical High $4,466.84 | Facility | None | $102.33 | $436.52 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $831.76 | Professional | None | $112.20 | $218.78 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $162.18 Typical High $630.96 | Professional | 54 · Surgery only | $77.62 | $162.18 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $32.36 Typical High $125.89 | Professional | 55 · Aftercare only | $15.49 | $32.36 | $125.89 |
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 $138.04 Median $138.04 Typical High $588.84 | Facility | None | $138.04 | $138.04 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $588.84 | Professional | None | $138.04 | $234.42 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $162.18 Typical High $380.19 | Professional | 54 · Surgery only | $102.33 | $162.18 | $380.19 |
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 $141.25 Median $190.55 Typical High $562.34 | Professional | None | $141.25 | $190.55 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $2,344.23 | Facility | None | $281.84 | $288.40 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $281.84 Typical High $338.84 | Professional | None | $87.10 | $281.84 | $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 $83.18 Median $208.93 Typical High $436.52 | Professional | None | $83.18 | $208.93 | $436.52 |
10 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 $51.29 Median $109.65 Typical High $416.87 | Professional | 52 · Reduced service | $51.29 | $109.65 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $43.65 Typical High $165.96 | Professional | 53 · Discontinued | $20.42 | $43.65 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $21.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $10.23 | $21.88 | $83.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $151.36 Median $177.83 Typical High $676.08 | Professional | 63 · Small infant | $151.36 | $177.83 | $676.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $104.71 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $89.13 | $104.71 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $109.65 Typical High $416.87 | Professional | 52 · Reduced service | $51.29 | $109.65 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $43.65 Typical High $165.96 | Professional | 53 · Discontinued | $20.42 | $43.65 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $21.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $10.23 | $21.88 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $53.70 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $173.78 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $109.65 | $173.78 | $407.38 |
Where Idaho sits
The same service costs 9.0 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 $4,579MT $507
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.