How much rates vary
Facilitymedian $1,047 · 10th to 90th $550 to $4,467Professionalmedian $603 · 10th to 90th $275 to $1,778
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 $691.83 Median $3,162.28 Typical High $5,495.41 | Facility | None | $691.83 | $3,162.28 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $831.76 Typical High $2,630.27 | Professional | None | $263.03 | $831.76 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $616.60 Typical High $1,995.26 | Professional | 54 · Surgery only | $194.98 | $616.60 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $123.03 Typical High $398.11 | Professional | 55 · Aftercare only | $38.90 | $123.03 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $4,897.79 | Facility | None | $1,584.89 | $2,570.40 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $1,122.02 Typical High $1,778.28 | Professional | None | $323.59 | $1,122.02 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $1,584.89 | Professional | 54 · Surgery only | $281.84 | $331.13 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $35.48 Typical High $169.82 | Professional | 55 · Aftercare only | $30.20 | $35.48 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $1,445.44 | Professional | None | $275.42 | $537.03 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,621.81 Typical High $5,495.41 | Facility | None | $575.44 | $1,621.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $831.76 Typical High $2,630.27 | Professional | None | $275.42 | $831.76 | $2,630.27 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $616.60 Typical High $1,995.26 | Professional | 54 · Surgery only | $194.98 | $616.60 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $123.03 Typical High $398.11 | Professional | 55 · Aftercare only | $38.90 | $123.03 | $398.11 |
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 $1,621.81 | Facility | None | $331.13 | $331.13 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $602.56 Typical High $1,698.24 | Professional | None | $331.13 | $602.56 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $416.87 Typical High $1,174.90 | Professional | 54 · Surgery only | $263.03 | $416.87 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $1,737.80 | Professional | None | $371.54 | $478.63 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $3,981.07 | Facility | None | $776.25 | $776.25 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $776.25 Typical High $1,071.52 | Professional | None | $204.17 | $776.25 | $1,071.52 |
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 $218.78 Median $724.44 Typical High $1,513.56 | Professional | None | $218.78 | $724.44 | $1,513.56 |
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 $131.83 Median $416.87 Typical High $1,318.26 | Professional | 52 · Reduced service | $131.83 | $416.87 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $165.96 Typical High $537.03 | Professional | 53 · Discontinued | $52.48 | $165.96 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $83.18 Typical High $263.03 | Professional | 56 · Pre-op care only | $26.30 | $83.18 | $263.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $724.44 Typical High $2,137.96 | Professional | 63 · Small infant | $363.08 | $724.44 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $239.88 | $1,174.90 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $416.87 Typical High $1,318.26 | Professional | 52 · Reduced service | $131.83 | $416.87 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $165.96 Typical High $537.03 | Professional | 53 · Discontinued | $52.48 | $165.96 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $83.18 Typical High $263.03 | Professional | 56 · Pre-op care only | $26.30 | $83.18 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $60.26 Typical High $169.82 | Professional | 56 · Pre-op care only | $38.02 | $60.26 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $1,258.93 |
Where Idaho sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $977
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.