How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,175 to $14,454Professionalmedian $513 · 10th to 90th $339 to $813
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $812.83 Typical High $812.83 | Professional | None | $346.74 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $251.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $50.12 | $123.03 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,290.87 Median $4,466.84 Typical High $16,982.44 | Facility | None | $2,290.87 | $4,466.84 | $16,982.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | None | $457.09 | $537.03 | $562.34 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $5,623.41 | Facility | None | $3,715.35 | $4,168.69 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $467.74 | Professional | None | $354.81 | $407.38 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $812.83 Typical High $5,495.41 | Facility | None | $363.08 | $812.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $812.83 | Professional | None | $363.08 | $537.03 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $269.15 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $53.70 | $123.03 | $123.03 |
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 $407.38 Median $501.19 Typical High $501.19 | Facility | None | $407.38 | $501.19 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | None | $501.19 | $501.19 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $14,454.40 Typical High $24,547.09 | Facility | None | $7,585.78 | $14,454.40 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $549.54 | Professional | None | $457.09 | $537.03 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $5,370.32 | Facility | None | $234.42 | $239.88 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $524.81 | Professional | None | $234.42 | $234.42 | $524.81 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $630.96 | Professional | None | $302.00 | $416.87 | $630.96 |
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 $169.82 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $169.82 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $67.61 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $33.88 | $81.28 | $81.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $549.54 Median $630.96 Typical High $660.69 | Professional | 63 · Small infant | $549.54 | $630.96 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $181.97 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $72.44 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $36.31 | $81.28 | $81.28 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 22 · Increased work | $588.84 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 63 · Small infant | $588.84 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.