How much rates vary
Facilitymedian $1,413 · 10th to 90th $537 to $4,467Professionalmedian $468 · 10th to 90th $302 to $1,072
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 $501.19 Median $1,071.52 Typical High $4,466.84 | Facility | None | $501.19 | $1,071.52 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $1,071.52 | Professional | None | $281.84 | $512.86 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $354.81 Typical High $812.83 | Professional | 54 · Surgery only | $208.93 | $354.81 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $331.13 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $194.98 | $331.13 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $5,011.87 | Facility | None | $1,000.00 | $1,862.09 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $676.08 Typical High $977.24 | Professional | None | $323.59 | $676.08 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $851.14 | Professional | 54 · Surgery only | $316.23 | $436.52 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $245.47 | $338.84 | $660.69 |
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 $316.23 Median $416.87 Typical High $676.08 | Professional | None | $316.23 | $416.87 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,230.27 Typical High $4,073.80 | Facility | None | $467.74 | $1,230.27 | $4,073.80 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $524.81 Typical High $1,071.52 | Professional | None | $281.84 | $524.81 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $354.81 Typical High $812.83 | Professional | 54 · Surgery only | $208.93 | $354.81 | $812.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $331.13 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $194.98 | $331.13 | $758.58 |
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 $338.84 Median $891.25 Typical High $1,862.09 | Facility | None | $338.84 | $891.25 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $1,122.02 | Professional | None | $338.84 | $478.63 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $758.58 | Professional | 54 · Surgery only | $338.84 | $338.84 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $812.83 |
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 $380.19 Median $616.60 Typical High $1,047.13 | Professional | None | $380.19 | $616.60 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $1,778.28 | Facility | None | $426.58 | $436.52 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $426.58 Typical High $1,071.52 | Professional | None | $194.98 | $426.58 | $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 $245.47 Median $457.09 Typical High $794.33 | Professional | None | $245.47 | $457.09 | $794.33 |
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 $141.25 Median $234.42 Typical High $537.03 | Professional | 52 · Reduced service | $141.25 | $234.42 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $93.33 Typical High $218.78 | Professional | 53 · Discontinued | $56.23 | $93.33 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $70.79 Typical High $162.18 | Professional | 55 · Aftercare only | $42.66 | $70.79 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $46.77 Typical High $107.15 | Professional | 56 · Pre-op care only | $28.18 | $46.77 | $107.15 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,412.54 Median $2,818.38 Typical High $7,585.78 | Facility | 50 · Both sides | $1,412.54 | $2,818.38 | $7,585.78 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $575.44 Typical High $1,445.44 | Professional | 50 · Both sides | $478.63 | $575.44 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $37.15 Typical High $100.00 | Professional | 55 · Aftercare only | $31.62 | $37.15 | $100.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $380.19 Median $1,000.00 Typical High $1,202.26 | Professional | 63 · Small infant | $380.19 | $1,000.00 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $234.42 Typical High $537.03 | Professional | 52 · Reduced service | $141.25 | $234.42 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $93.33 Typical High $218.78 | Professional | 53 · Discontinued | $56.23 | $93.33 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $70.79 Typical High $162.18 | Professional | 55 · Aftercare only | $42.66 | $70.79 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $46.77 Typical High $107.15 | Professional | 56 · Pre-op care only | $28.18 | $46.77 | $107.15 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $724.44 Typical High $1,621.81 | Professional | 50 · Both sides | $724.44 | $724.44 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $107.15 |
Where Idaho sits
The same service costs 4.6 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 $4,728MT $1,029
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.