How much rates vary
Facilitymedian $2,138 · 10th to 90th $813 to $7,943Professionalmedian $851 · 10th to 90th $437 to $1,862
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 $933.25 Median $1,621.81 Typical High $5,495.41 | Facility | None | $933.25 | $1,621.81 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $891.25 Typical High $2,041.74 | Professional | None | $407.38 | $891.25 | $2,041.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $9,120.11 | Facility | None | $1,949.84 | $3,467.37 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $1,348.96 Typical High $1,905.46 | Professional | None | $524.81 | $1,348.96 | $1,905.46 |
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 $489.78 Median $724.44 Typical High $1,445.44 | Professional | None | $489.78 | $724.44 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,621.81 Typical High $7,943.28 | Facility | None | $436.52 | $1,621.81 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $977.24 Typical High $2,041.74 | Professional | None | $436.52 | $977.24 | $2,041.74 |
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 $602.56 Median $602.56 Typical High $1,698.24 | Facility | None | $602.56 | $602.56 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,819.70 | Professional | None | $602.56 | $1,047.13 | $1,819.70 |
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 $524.81 Median $691.83 Typical High $1,479.11 | Professional | None | $524.81 | $691.83 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $5,011.87 | Facility | None | $812.83 | $812.83 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $812.83 Typical High $1,071.52 | Professional | None | $371.54 | $812.83 | $1,071.52 |
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 $380.19 Median $812.83 Typical High $1,548.82 | Professional | None | $380.19 | $812.83 | $1,548.82 |
14 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 $218.78 Median $389.05 Typical High $1,023.29 | Professional | 52 · Reduced service | $218.78 | $389.05 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $154.88 Typical High $407.38 | Professional | 53 · Discontinued | $87.10 | $154.88 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $588.84 Typical High $1,513.56 | Professional | 54 · Surgery only | $331.13 | $588.84 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $117.49 Typical High $309.03 | Professional | 55 · Aftercare only | $66.07 | $117.49 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $77.62 Typical High $204.17 | Professional | 56 · Pre-op care only | $43.65 | $77.62 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $1,412.54 Typical High $1,659.59 | Professional | 54 · Surgery only | $512.86 | $1,412.54 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $165.96 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $165.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $812.83 Typical High $2,290.87 | Professional | 63 · Small infant | $660.69 | $812.83 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $1,000.00 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $426.58 | $1,000.00 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $389.05 Typical High $1,023.29 | Professional | 52 · Reduced service | $218.78 | $389.05 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $154.88 Typical High $407.38 | Professional | 53 · Discontinued | $87.10 | $154.88 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $588.84 Typical High $1,513.56 | Professional | 54 · Surgery only | $331.13 | $588.84 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $117.49 Typical High $309.03 | Professional | 55 · Aftercare only | $66.07 | $117.49 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $77.62 Typical High $204.17 | Professional | 56 · Pre-op care only | $43.65 | $77.62 | $204.17 |
Where Idaho sits
The same service costs 3.7 times more in Wisconsin than in North Dakota. 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
WI $6,561ND $1,783
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.