How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,413 to $15,488Professionalmedian $813 · 10th to 90th $427 to $5,129
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 $331.13 Median $812.83 Typical High $5,370.32 | Professional | None | $331.13 | $812.83 | $5,370.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $602.56 Typical High $4,073.80 | Professional | 54 · Surgery only | $316.23 | $602.56 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $120.23 Typical High $812.83 | Professional | 55 · Aftercare only | $63.10 | $120.23 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $562.34 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $295.12 | $562.34 | $3,801.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,630.27 Median $8,128.31 Typical High $17,782.79 | Facility | None | $2,630.27 | $8,128.31 | $17,782.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $3,311.31 Typical High $4,677.35 | Professional | None | $549.54 | $3,311.31 | $4,677.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $3,548.13 Typical High $4,365.16 | Professional | 54 · Surgery only | $478.63 | $3,548.13 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $407.38 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $2,691.53 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $371.54 | $2,691.53 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $6,309.57 Median $7,079.46 Typical High $9,772.37 | Facility | None | $6,309.57 | $7,079.46 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $3,388.44 | Professional | None | $426.58 | $575.44 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,412.54 Typical High $7,079.46 | Facility | None | $234.42 | $1,412.54 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $5,370.32 | Professional | None | $467.74 | $812.83 | $5,370.32 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $602.56 Typical High $4,073.80 | Professional | 54 · Surgery only | $316.23 | $602.56 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $120.23 Typical High $812.83 | Professional | 55 · Aftercare only | $63.10 | $120.23 | $812.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $562.34 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $295.12 | $562.34 | $3,801.89 |
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 $575.44 Median $575.44 Typical High $4,265.80 | Facility | None | $575.44 | $575.44 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $5,370.32 | Professional | None | $575.44 | $851.14 | $5,370.32 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $3,630.78 | Professional | 54 · Surgery only | $562.34 | $562.34 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $22,387.21 | Facility | None | $12,022.64 | $16,982.44 | $22,387.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $5,128.61 | Professional | None | $645.65 | $891.25 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $11,481.54 | Facility | None | $2,041.74 | $2,089.30 | $11,481.54 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $2,041.74 Typical High $6,456.54 | Professional | None | $331.13 | $2,041.74 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $6,456.54 | Facility | None | $1,288.25 | $2,818.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $2,754.23 | Professional | None | $199.53 | $371.54 | $2,754.23 |
8 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 $213.80 Median $398.11 Typical High $2,691.53 | Professional | 52 · Reduced service | $213.80 | $398.11 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $1,071.52 | Professional | 53 · Discontinued | $85.11 | $162.18 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $537.03 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $537.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $645.65 Median $758.58 Typical High $5,248.07 | Professional | 63 · Small infant | $645.65 | $758.58 | $5,248.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $398.11 Typical High $2,691.53 | Professional | 52 · Reduced service | $213.80 | $398.11 | $2,691.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $1,071.52 | Professional | 53 · Discontinued | $85.11 | $162.18 | $1,071.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $81.28 Typical High $537.03 | Professional | 56 · Pre-op care only | $42.66 | $81.28 | $537.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $524.81 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $524.81 |
Where Idaho sits
The same service costs 13.1 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 $15,603MT $1,192
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.