How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,047 to $11,749Professionalmedian $617 · 10th to 90th $437 to $891
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 $630.96 Median $1,071.52 Typical High $8,709.64 | Facility | None | $630.96 | $1,071.52 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $891.25 | Professional | None | $389.05 | $501.19 | $891.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $13,489.63 | Facility | None | $2,511.89 | $4,677.35 | $13,489.63 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,715.35 Median $6,606.93 Typical High $20,417.38 | Facility | 50 · Both sides | $3,715.35 | $6,606.93 | $20,417.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $870.96 | Professional | None | $588.84 | $691.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,570.88 | Facility | None | $3,019.95 | $3,388.44 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $676.08 | Professional | None | $489.78 | $575.44 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $3,388.44 Typical High $10,232.93 | Facility | None | $501.19 | $3,388.44 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $891.25 | Professional | None | $467.74 | $691.83 | $891.25 |
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 $549.54 Median $676.08 Typical High $676.08 | Facility | None | $549.54 | $676.08 | $676.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,174.90 | Professional | None | $676.08 | $676.08 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $12,302.69 Typical High $16,982.44 | Facility | None | $8,511.38 | $12,302.69 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | None | $588.84 | $588.84 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $8,709.64 | Facility | None | $323.59 | $331.13 | $8,709.64 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $501.19 | Professional | None | $323.59 | $323.59 | $501.19 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,548.13 | Facility | None | $1,698.24 | $2,238.72 | $3,548.13 |
United Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $831.76 | Professional | None | $426.58 | $588.84 | $831.76 |
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 $245.47 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $245.47 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $97.72 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $371.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $74.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $48.98 | $89.13 | $89.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $645.65 | $676.08 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $75.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $724.44 Median $870.96 Typical High $912.01 | Professional | 63 · Small infant | $724.44 | $870.96 | $912.01 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $245.47 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $97.72 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $371.54 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $74.13 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $48.98 | $89.13 | $89.13 |
Where Idaho sits
The same service costs 7.3 times more in Wisconsin 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
WI $8,816MT $1,205
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.