How much rates vary
Facilitymedian $1,445 · 10th to 90th $407 to $5,754Professionalmedian $229 · 10th to 90th $162 to $331
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 $257.04 Median $4,466.84 Typical High $7,244.36 | Facility | None | $257.04 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $354.81 | Professional | None | $169.82 | $288.40 | $354.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $6,025.60 | Facility | None | $1,348.96 | $2,238.72 | $6,025.60 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $1,995.26 Median $2,951.21 Typical High $9,120.11 | Facility | 50 · Both sides | $1,995.26 | $2,951.21 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $331.13 | Professional | None | $213.80 | $257.04 | $331.13 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $380.19 Typical High $501.19 | Professional | 50 · Both sides | $323.59 | $380.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $223.87 | Professional | None | $162.18 | $186.21 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $407.38 Typical High $5,495.41 | Facility | None | $204.17 | $407.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $331.13 | Professional | None | $169.82 | $223.87 | $331.13 |
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 $190.55 Median $229.09 Typical High $229.09 | Facility | None | $190.55 | $229.09 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $331.13 | Professional | None | $199.53 | $229.09 | $331.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | None | $223.87 | $269.15 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $3,630.78 | Facility | None | $109.65 | $112.20 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $1,445.44 | Professional | None | $109.65 | $173.78 | $1,445.44 |
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 $144.54 Median $218.78 Typical High $354.81 | Professional | None | $144.54 | $218.78 | $354.81 |
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 $102.33 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $102.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $40.74 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $20.42 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $199.53 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $223.87 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $223.87 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $33.11 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $33.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $251.19 Median $295.12 Typical High $398.11 | Professional | 63 · Small infant | $251.19 | $295.12 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $144.54 | $173.78 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $104.71 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $41.69 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $154.88 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $20.89 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $144.54 | $199.53 | $199.53 |
Where Idaho sits
The same service costs 11.0 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 $4,556MT $413
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.