How much rates vary
Facilitymedian $1,738 · 10th to 90th $759 to $5,248Professionalmedian $525 · 10th to 90th $355 to $646
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 $758.58 Median $776.25 Typical High $8,709.64 | Facility | None | $758.58 | $776.25 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $645.65 | Professional | None | $338.84 | $457.09 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,041.74 | $6,165.95 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $3,162.28 Typical High $9,120.11 | Facility | 50 · Both sides | $2,511.89 | $3,162.28 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $660.69 | Professional | None | $501.19 | $602.56 | $660.69 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,096.48 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,096.48 |
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 $407.38 Median $467.74 Typical High $549.54 | Professional | None | $407.38 | $467.74 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $912.01 Typical High $4,897.79 | Facility | None | $426.58 | $912.01 | $4,897.79 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $645.65 | Professional | None | $363.08 | $602.56 | $645.65 |
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 $588.84 Median $588.84 Typical High $1,949.84 | Facility | None | $588.84 | $588.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
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 $501.19 Median $501.19 Typical High $616.60 | Professional | None | $501.19 | $501.19 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $6,165.95 | Facility | None | $275.42 | $281.84 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
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 $331.13 Median $467.74 Typical High $660.69 | Professional | None | $331.13 | $467.74 | $660.69 |
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 $190.55 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $190.55 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $75.86 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $56.23 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $38.02 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $446.68 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $562.34 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $741.31 Typical High $794.33 | Professional | 63 · Small infant | $630.96 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $213.80 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $85.11 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $323.59 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $42.66 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $302.00 | $446.68 | $446.68 |
Where Idaho sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.