How much rates vary
Facilitymedian $1,380 · 10th to 90th $229 to $4,786Professionalmedian $191 · 10th to 90th $129 to $282
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 $128.82 Median $190.55 Typical High $281.84 | Professional | None | $128.82 | $190.55 | $281.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $4,786.30 | Facility | None | $1,380.38 | $1,905.46 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $302.00 | Professional | None | $151.36 | $218.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $223.87 | Professional | None | $131.83 | $169.82 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $275.42 Typical High $5,495.41 | Facility | None | $85.11 | $275.42 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $281.84 | Professional | None | $147.91 | $190.55 | $281.84 |
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 $177.83 Median $177.83 Typical High $281.84 | Facility | None | $177.83 | $177.83 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $302.00 | Professional | None | $177.83 | $281.84 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $234.42 | Professional | None | $151.36 | $194.98 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $3,890.45 | Facility | None | $134.90 | $134.90 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $177.83 | Professional | None | $112.20 | $134.90 | $177.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $257.04 | Professional | None | $102.33 | $162.18 | $257.04 |
16 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 $64.57 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $64.57 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $56.23 | Professional | 53 · Discontinued | $25.70 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $97.72 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $194.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $147.91 | $234.42 | $281.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $30.20 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $199.53 Median $309.03 Typical High $380.19 | Professional | 63 · Small infant | $199.53 | $309.03 | $380.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $95.50 Typical High $141.25 | Professional | 52 · Reduced service | $64.57 | $95.50 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $56.23 | Professional | 53 · Discontinued | $25.70 | $38.02 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $97.72 | $144.54 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $194.98 |
Where Idaho sits
The same service costs 13.0 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 $4,547MT $350
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.