How much rates vary
Facilitymedian $2,089 · 10th to 90th $832 to $7,244Professionalmedian $955 · 10th to 90th $339 to $2,455
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 $3,090.30 Typical High $5,495.41 | Facility | None | $691.83 | $3,090.30 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,174.90 Typical High $2,630.27 | Professional | None | $323.59 | $1,174.90 | $2,630.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,380.38 | $2,344.23 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $380.19 Median $1,584.89 Typical High $2,290.87 | Professional | None | $380.19 | $1,584.89 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $1,862.09 | Professional | None | $363.08 | $524.81 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $6,606.93 | Facility | None | $575.44 | $2,630.27 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $1,202.26 Typical High $2,630.27 | Professional | None | $363.08 | $1,202.26 | $2,630.27 |
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 $436.52 Median $436.52 Typical High $2,089.30 | Facility | None | $436.52 | $436.52 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $2,238.72 | Professional | None | $436.52 | $758.58 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,905.46 | Professional | None | $380.19 | $501.19 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $2,454.71 | Facility | None | $1,000.00 | $1,023.29 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $1,000.00 Typical High $1,380.38 | Professional | None | $269.15 | $1,000.00 | $1,380.38 |
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 $281.84 Median $954.99 Typical High $2,041.74 | Professional | None | $281.84 | $954.99 | $2,041.74 |
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 $162.18 Median $288.40 Typical High $1,318.26 | Professional | 52 · Reduced service | $162.18 | $288.40 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $114.82 Typical High $524.81 | Professional | 53 · Discontinued | $64.57 | $114.82 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $436.52 Typical High $1,949.84 | Professional | 54 · Surgery only | $239.88 | $436.52 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $87.10 Typical High $389.05 | Professional | 55 · Aftercare only | $47.86 | $87.10 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $57.54 Typical High $263.03 | Professional | 56 · Pre-op care only | $32.36 | $57.54 | $263.03 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,089.30 Median $3,467.37 Typical High $13,489.63 | Facility | 50 · Both sides | $2,089.30 | $3,467.37 | $13,489.63 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $2,884.03 Typical High $3,548.13 | Professional | 50 · Both sides | $616.60 | $2,884.03 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $1,949.84 | Professional | 54 · Surgery only | $363.08 | $436.52 | $1,949.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $234.42 | Professional | 55 · Aftercare only | $39.81 | $56.23 | $234.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $537.03 Median $2,290.87 Typical High $2,818.38 | Professional | 63 · Small infant | $537.03 | $2,290.87 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $288.40 Typical High $1,318.26 | Professional | 52 · Reduced service | $162.18 | $288.40 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $114.82 Typical High $524.81 | Professional | 53 · Discontinued | $64.57 | $114.82 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $436.52 Typical High $1,949.84 | Professional | 54 · Surgery only | $239.88 | $436.52 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $87.10 Typical High $389.05 | Professional | 55 · Aftercare only | $47.86 | $87.10 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $57.54 Typical High $263.03 | Professional | 56 · Pre-op care only | $32.36 | $57.54 | $263.03 |
Where Idaho sits
The same service costs 3.2 times more in Oklahoma 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
OK $6,075KY $1,891
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.