How much rates vary
Facilitymedian $1,413 · 10th to 90th $324 to $5,495Professionalmedian $251 · 10th to 90th $182 to $355
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $354.81 | Professional | None | $181.97 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $134.90 | $239.88 | $269.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $6,165.95 | Facility | None | $1,348.96 | $2,041.74 | $6,165.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $346.74 | Professional | None | $218.78 | $269.15 | $346.74 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $239.88 | $316.23 |
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 $181.97 Median $223.87 Typical High $257.04 | Professional | None | $181.97 | $223.87 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $5,495.41 | Facility | None | $154.88 | $354.81 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $354.81 | Professional | None | $186.21 | $288.40 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $134.90 | $239.88 | $269.15 |
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 $251.19 Median $251.19 Typical High $323.59 | Facility | None | $251.19 | $251.19 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $354.81 | Professional | None | $251.19 | $323.59 | $354.81 |
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 $218.78 Median $245.47 Typical High $281.84 | Professional | None | $218.78 | $245.47 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $6,165.95 | Facility | None | $154.88 | $158.49 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | None | $154.88 | $154.88 | $204.17 |
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 $154.88 Median $218.78 Typical High $323.59 | Professional | None | $154.88 | $218.78 | $323.59 |
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 $89.13 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $89.13 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $26.92 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $32.36 | $35.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $26.92 | $34.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $323.59 Typical High $436.52 | Professional | 63 · Small infant | $275.42 | $323.59 | $436.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $208.93 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $89.13 | $158.49 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $64.57 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $26.92 | $47.86 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $32.36 | $35.48 |
Where Idaho sits
The same service costs 10.0 times more in Colorado 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
CO $4,594ND $460
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.