How much rates vary
Facilitymedian $1,778 · 10th to 90th $589 to $6,761Professionalmedian $525 · 10th to 90th $251 to $1,318
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 $190.55 Median $524.81 Typical High $1,621.81 | Professional | None | $190.55 | $524.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $389.05 Typical High $1,202.26 | Professional | 54 · Surgery only | $186.21 | $389.05 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $79.43 Typical High $239.88 | Professional | 55 · Aftercare only | $37.15 | $79.43 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $363.08 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $173.78 | $363.08 | $1,122.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $7,244.36 | Facility | None | $1,445.44 | $2,630.27 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $316.23 Median $831.76 Typical High $1,318.26 | Professional | None | $316.23 | $831.76 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $275.42 | $977.24 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $107.15 Typical High $131.83 | Professional | 55 · Aftercare only | $30.90 | $107.15 | $131.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $251.19 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $213.80 | $251.19 | $912.01 |
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 $251.19 Median $389.05 Typical High $870.96 | Professional | None | $251.19 | $389.05 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,412.54 Typical High $7,244.36 | Facility | None | $245.47 | $1,412.54 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $524.81 Typical High $1,621.81 | Professional | None | $245.47 | $524.81 | $1,621.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $389.05 Typical High $1,202.26 | Professional | 54 · Surgery only | $186.21 | $389.05 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $79.43 Typical High $239.88 | Professional | 55 · Aftercare only | $37.15 | $79.43 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $363.08 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $173.78 | $363.08 | $1,122.02 |
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 $331.13 Median $331.13 Typical High $1,202.26 | Facility | None | $331.13 | $331.13 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $1,202.26 | Professional | None | $331.13 | $562.34 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $758.58 | Professional | 54 · Surgery only | $251.19 | $398.11 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $426.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $269.15 | $426.58 | $812.83 |
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 $346.74 Median $457.09 Typical High $1,122.02 | Professional | None | $346.74 | $457.09 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $3,715.35 | Facility | None | $575.44 | $588.84 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $575.44 Typical High $691.83 | Professional | None | $213.80 | $575.44 | $691.83 |
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 $199.53 Median $446.68 Typical High $977.24 | Professional | None | $199.53 | $446.68 | $977.24 |
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 $123.03 Median $263.03 Typical High $812.83 | Professional | 52 · Reduced service | $123.03 | $263.03 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $104.71 Typical High $323.59 | Professional | 53 · Discontinued | $50.12 | $104.71 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $52.48 Typical High $162.18 | Professional | 56 · Pre-op care only | $24.55 | $52.48 | $162.18 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $416.87 Median $436.52 Typical High $1,548.82 | Professional | 63 · Small infant | $416.87 | $436.52 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $263.03 Typical High $812.83 | Professional | 52 · Reduced service | $123.03 | $263.03 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $104.71 Typical High $323.59 | Professional | 53 · Discontinued | $50.12 | $104.71 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $52.48 Typical High $162.18 | Professional | 56 · Pre-op care only | $24.55 | $52.48 | $162.18 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $107.15 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $107.15 |
Where Idaho sits
The same service costs 4.4 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 $4,844ND $1,099
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.