How much rates vary
Facilitymedian $1,413 · 10th to 90th $832 to $5,012Professionalmedian $1,122 · 10th to 90th $646 to $1,820
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 $1,348.96 Median $2,238.72 Typical High $5,495.41 | Facility | None | $1,348.96 | $2,238.72 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,905.46 | Professional | None | $588.84 | $1,122.02 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $851.14 Typical High $1,412.54 | Professional | 54 · Surgery only | $446.68 | $851.14 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $794.33 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $416.87 | $794.33 | $1,318.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $5,011.87 | Facility | None | $1,288.25 | $2,238.72 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,778.28 | Professional | None | $794.33 | $1,258.93 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,288.25 Typical High $1,584.89 | Professional | 54 · Surgery only | $691.83 | $1,288.25 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,584.89 | Facility | None | $1,047.13 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,230.27 | Professional | None | $645.65 | $831.76 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $7,244.36 | Facility | None | $489.78 | $1,412.54 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,905.46 | Professional | None | $741.31 | $1,122.02 | $1,905.46 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $851.14 Typical High $1,412.54 | Professional | 54 · Surgery only | $446.68 | $851.14 | $1,412.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $794.33 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $416.87 | $794.33 | $1,318.26 |
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 $831.76 Median $831.76 Typical High $1,621.81 | Facility | None | $831.76 | $831.76 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,041.74 | Professional | None | $831.76 | $1,148.15 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,288.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $6,309.57 | Facility | None | $3,388.44 | $4,897.79 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,819.70 | Professional | None | $977.24 | $1,122.02 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $3,548.13 | Facility | None | $776.25 | $794.33 | $3,548.13 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,071.52 | Professional | None | $467.74 | $776.25 | $1,071.52 |
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 $537.03 Median $851.14 Typical High $1,445.44 | Professional | None | $537.03 | $851.14 | $1,445.44 |
14 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 $295.12 Median $562.34 Typical High $954.99 | Professional | 52 · Reduced service | $295.12 | $562.34 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $223.87 Typical High $380.19 | Professional | 53 · Discontinued | $117.49 | $223.87 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $169.82 Typical High $281.84 | Professional | 55 · Aftercare only | $89.13 | $169.82 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $112.20 Typical High $190.55 | Professional | 56 · Pre-op care only | $58.88 | $112.20 | $190.55 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,949.84 Median $3,311.31 Typical High $7,585.78 | Facility | 50 · Both sides | $1,949.84 | $3,311.31 | $7,585.78 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $2,238.72 Typical High $2,754.23 | Professional | 50 · Both sides | $1,148.15 | $2,238.72 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $114.82 Typical High $177.83 | Professional | 55 · Aftercare only | $77.62 | $114.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $933.25 Median $1,698.24 Typical High $2,187.76 | Professional | 63 · Small infant | $933.25 | $1,698.24 | $2,187.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $562.34 Typical High $954.99 | Professional | 52 · Reduced service | $295.12 | $562.34 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $223.87 Typical High $380.19 | Professional | 53 · Discontinued | $117.49 | $223.87 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $169.82 Typical High $281.84 | Professional | 55 · Aftercare only | $89.13 | $169.82 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $112.20 Typical High $190.55 | Professional | 56 · Pre-op care only | $58.88 | $112.20 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,737.80 Typical High $2,818.38 | Professional | 50 · Both sides | $1,737.80 | $1,737.80 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $186.21 |
Where Idaho sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.