How much rates vary
Facilitymedian $1,778 · 10th to 90th $562 to $6,310Professionalmedian $372 · 10th to 90th $178 to $977
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 $177.83 Median $436.52 Typical High $1,288.25 | Professional | None | $177.83 | $436.52 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $309.03 Typical High $954.99 | Professional | 54 · Surgery only | $131.83 | $309.03 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $61.66 Typical High $190.55 | Professional | 55 · Aftercare only | $26.30 | $61.66 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $288.40 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $123.03 | $288.40 | $891.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,445.44 | $2,754.23 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $616.60 Typical High $977.24 | Professional | None | $223.87 | $616.60 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $851.14 | Professional | 54 · Surgery only | $194.98 | $229.09 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $97.72 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,584.89 | $1,778.28 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $691.83 | Professional | None | $177.83 | $309.03 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $5,495.41 | Facility | None | $162.18 | $562.34 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $1,288.25 | Professional | None | $199.53 | $446.68 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $309.03 Typical High $954.99 | Professional | 54 · Surgery only | $131.83 | $309.03 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $61.66 Typical High $190.55 | Professional | 55 · Aftercare only | $26.30 | $61.66 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $288.40 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $123.03 | $288.40 | $891.25 |
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 $234.42 Median $234.42 Typical High $891.25 | Facility | None | $234.42 | $234.42 | $891.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $891.25 | Professional | None | $234.42 | $398.11 | $891.25 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $281.84 Typical High $602.56 | Professional | 54 · Surgery only | $177.83 | $281.84 | $602.56 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,309.57 Typical High $9,120.11 | Facility | None | $4,786.30 | $6,309.57 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $891.25 | Professional | None | $245.47 | $323.59 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $5,011.87 | Facility | None | $426.58 | $436.52 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $426.58 Typical High $549.54 | Professional | None | $147.91 | $426.58 | $549.54 |
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 $141.25 Median $346.74 Typical High $812.83 | Professional | None | $141.25 | $346.74 | $812.83 |
8 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 $208.93 Typical High $630.96 | Professional | 52 · Reduced service | $87.10 | $208.93 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $83.18 Typical High $257.04 | Professional | 53 · Discontinued | $35.48 | $83.18 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $41.69 Typical High $128.82 | Professional | 56 · Pre-op care only | $17.78 | $41.69 | $128.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $263.03 Median $309.03 Typical High $1,148.15 | Professional | 63 · Small infant | $263.03 | $309.03 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $208.93 Typical High $630.96 | Professional | 52 · Reduced service | $87.10 | $208.93 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $83.18 Typical High $257.04 | Professional | 53 · Discontinued | $35.48 | $83.18 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $41.69 Typical High $128.82 | Professional | 56 · Pre-op care only | $17.78 | $41.69 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $39.81 Typical High $85.11 | Professional | 56 · Pre-op care only | $25.12 | $39.81 | $85.11 |
Where Idaho sits
The same service costs 5.6 times more in Colorado than in North Dakota. 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 $4,763ND $853
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.