How much rates vary
Facilitymedian $2,692 · 10th to 90th $933 to $8,913Professionalmedian $603 · 10th to 90th $447 to $891
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 $1,071.52 Median $1,412.54 Typical High $7,079.46 | Facility | None | $1,071.52 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $891.25 Typical High $891.25 | Professional | None | $363.08 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $354.81 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $70.79 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $630.96 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $9,120.11 | Facility | None | $2,137.96 | $3,801.89 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $645.65 | Professional | None | $537.03 | $602.56 | $645.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $537.03 | $588.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $64.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,388.44 | Facility | None | $2,187.76 | $2,454.71 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $575.44 | Professional | None | $436.52 | $512.86 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,412.54 Typical High $7,079.46 | Facility | None | $467.74 | $1,412.54 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $891.25 | Professional | None | $467.74 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $354.81 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $70.79 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $630.96 | $630.96 |
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 $467.74 Median $575.44 Typical High $575.44 | Facility | None | $467.74 | $575.44 | $575.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | None | $575.44 | $575.44 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,309.57 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,309.57 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $891.25 | Professional | None | $575.44 | $602.56 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $5,623.41 | Facility | None | $275.42 | $281.84 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $2,238.72 | Professional | None | $275.42 | $295.12 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $741.31 | Professional | None | $389.05 | $537.03 | $741.31 |
7 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 $234.42 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $234.42 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $93.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $46.77 | $89.13 | $89.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 63 · Small infant | $645.65 | $724.44 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $234.42 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $93.33 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $46.77 | $89.13 | $89.13 |
Where Idaho sits
The same service costs 7.3 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 $7,316MT $1,003
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.