How much rates vary
Facilitymedian $1,413 · 10th to 90th $525 to $5,248Professionalmedian $407 · 10th to 90th $263 to $708
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $812.83 | Professional | None | $239.88 | $457.09 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $338.84 Typical High $602.56 | Professional | 54 · Surgery only | $190.55 | $338.84 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,348.96 | $3,235.94 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $707.95 | Professional | None | $302.00 | $537.03 | $707.95 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $302.00 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $549.54 | Professional | None | $281.84 | $363.08 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $812.83 Typical High $4,786.30 | Facility | None | $257.04 | $812.83 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $812.83 | Professional | None | $263.03 | $457.09 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $338.84 Typical High $602.56 | Professional | 54 · Surgery only | $190.55 | $338.84 | $602.56 |
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 $346.74 Median $346.74 Typical High $645.65 | Facility | None | $346.74 | $346.74 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $691.83 | Professional | None | $346.74 | $602.56 | $691.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $6,606.93 | Facility | None | $3,467.37 | $5,248.07 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $575.44 | Professional | None | $302.00 | $398.11 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $4,466.84 | Facility | None | $309.03 | $316.23 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $426.58 | Professional | None | $218.78 | $309.03 | $426.58 |
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 $218.78 Median $354.81 Typical High $549.54 | Professional | None | $218.78 | $354.81 | $549.54 |
11 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 $128.82 Median $229.09 Typical High $407.38 | Professional | 52 · Reduced service | $128.82 | $229.09 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $91.20 Typical High $162.18 | Professional | 53 · Discontinued | $51.29 | $91.20 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $67.61 Typical High $123.03 | Professional | 55 · Aftercare only | $38.02 | $67.61 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $45.71 Typical High $81.28 | Professional | 56 · Pre-op care only | $25.70 | $45.71 | $81.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $32.36 | $60.26 | $72.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $389.05 Median $467.74 Typical High $870.96 | Professional | 63 · Small infant | $389.05 | $467.74 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $275.42 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $229.09 | $275.42 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $229.09 Typical High $407.38 | Professional | 52 · Reduced service | $128.82 | $229.09 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $91.20 Typical High $162.18 | Professional | 53 · Discontinued | $51.29 | $91.20 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $67.61 Typical High $123.03 | Professional | 55 · Aftercare only | $38.02 | $67.61 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $45.71 Typical High $81.28 | Professional | 56 · Pre-op care only | $25.70 | $45.71 | $81.28 |
Where Idaho sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.