How much rates vary
Facilitymedian $1,380 · 10th to 90th $316 to $4,786Professionalmedian $263 · 10th to 90th $174 to $389
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 $141.25 Median $263.03 Typical High $389.05 | Professional | None | $141.25 | $263.03 | $389.05 |
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 $204.17 Median $302.00 Typical High $426.58 | Professional | None | $204.17 | $302.00 | $426.58 |
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 $181.97 Median $229.09 Typical High $309.03 | Professional | None | $181.97 | $229.09 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $389.05 Typical High $4,466.84 | Facility | None | $173.78 | $389.05 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $389.05 | Professional | None | $173.78 | $263.03 | $389.05 |
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 $239.88 Median $239.88 Typical High $389.05 | Facility | None | $239.88 | $239.88 | $389.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $416.87 | Professional | None | $239.88 | $389.05 | $416.87 |
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 $204.17 Median $269.15 Typical High $316.23 | Professional | None | $204.17 | $269.15 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $3,890.45 | Facility | None | $186.21 | $190.55 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $251.19 | Professional | None | $151.36 | $186.21 | $251.19 |
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 $141.25 Median $223.87 Typical High $346.74 | Professional | None | $141.25 | $223.87 | $346.74 |
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 $87.10 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $87.10 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $77.62 | Professional | 53 · Discontinued | $34.67 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $131.83 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $38.90 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $275.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $199.53 | $338.84 | $398.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $43.65 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $263.03 Median $316.23 Typical High $446.68 | Professional | 63 · Small infant | $263.03 | $316.23 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $87.10 | $128.82 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $77.62 | Professional | 53 · Discontinued | $34.67 | $52.48 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $131.83 | $194.98 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $38.90 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $275.42 |
Where Idaho sits
The same service costs 9.9 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 $4,605MT $466
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.