How much rates vary
Facilitymedian $1,413 · 10th to 90th $263 to $5,248Professionalmedian $155 · 10th to 90th $107 to $219
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 $229.09 Median $1,412.54 Typical High $7,079.46 | Facility | None | $229.09 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $218.78 | Professional | None | $97.72 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $162.18 | $162.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $5,248.07 | Facility | None | $1,348.96 | $2,398.83 | $5,248.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $190.55 | Professional | None | $147.91 | $173.78 | $190.55 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $169.82 | Professional | 54 · Surgery only | $138.04 | $162.18 | $169.82 |
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 $123.03 Median $144.54 Typical High $169.82 | Professional | None | $123.03 | $144.54 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $1,412.54 Typical High $7,079.46 | Facility | None | $123.03 | $1,412.54 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $218.78 | Professional | None | $123.03 | $186.21 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $162.18 | $162.18 |
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 $138.04 Median $169.82 Typical High $169.82 | Facility | None | $138.04 | $169.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | None | $169.82 | $169.82 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $6,606.93 | Facility | None | $3,467.37 | $5,011.87 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | None | $147.91 | $147.91 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $4,073.80 | Facility | None | $81.28 | $83.18 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $123.03 | Professional | None | $81.28 | $81.28 | $123.03 |
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 $100.00 Median $141.25 Typical High $208.93 | Professional | None | $100.00 | $141.25 | $208.93 |
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 $60.26 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $60.26 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $23.99 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $18.20 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.02 | $21.88 | $21.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $19.05 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $218.78 Typical High $229.09 | Professional | 63 · Small infant | $181.97 | $218.78 | $229.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $125.89 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $107.15 | $125.89 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $18.62 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $21.88 |
Where Idaho sits
The same service costs 15.6 times more in Colorado 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
CO $4,608MT $296
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.