How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,230 to $20,893Professionalmedian $1,230 · 10th to 90th $955 to $1,950
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,949.84 Typical High $1,949.84 | Professional | None | $954.99 | $1,949.84 | $1,949.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,311.31 Median $6,760.83 Typical High $23,988.33 | Facility | None | $3,311.31 | $6,760.83 | $23,988.33 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $10,000.00 Typical High $36,307.81 | Facility | 50 · Both sides | $4,786.30 | $10,000.00 | $36,307.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,258.93 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,344.23 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,495.41 | $6,165.95 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,258.93 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $5,623.41 | Facility | None | $1,023.29 | $1,949.84 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,348.96 | $1,949.84 |
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 $1,000.00 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,000.00 | $1,230.27 | $1,230.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,230.27 | $2,089.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,848.93 Median $22,908.68 Typical High $30,199.52 | Facility | None | $15,848.93 | $22,908.68 | $30,199.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $11,481.54 | Facility | None | $588.84 | $602.56 | $11,481.54 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $891.25 | Professional | None | $588.84 | $588.84 | $891.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
16 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 $549.54 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $549.54 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $218.78 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $812.83 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $162.18 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $109.65 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $758.58 | $1,380.38 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $138.04 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,318.26 Median $1,584.89 Typical High $1,659.59 | Professional | 63 · Small infant | $1,318.26 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $912.01 | $977.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $549.54 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $223.87 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $165.96 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $112.20 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $776.25 | $1,380.38 | $1,380.38 |
Where Idaho sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.