How much rates vary
Facilitymedian $257 · 10th to 90th $102 to $631Professionalmedian $120 · 10th to 90th $81 to $234
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 $102.33 Median $190.55 Typical High $288.40 | Facility | None | $102.33 | $190.55 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $177.83 | Professional | None | $72.44 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $83.18 | $128.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $85.11 Median $316.23 Typical High $602.56 | Facility | None | $85.11 | $316.23 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $288.40 | Professional | None | $89.13 | $173.78 | $288.40 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $102.33 Typical High $218.78 | Professional | 54 · Surgery only | $89.13 | $102.33 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $177.83 | Professional | None | $81.28 | $125.89 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $251.19 Typical High $1,071.52 | Facility | None | $107.15 | $251.19 | $1,071.52 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $229.09 | Professional | None | $63.10 | $112.20 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $67.61 | $128.82 |
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 $89.13 Median $93.33 Typical High $229.09 | Facility | None | $89.13 | $93.33 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $269.15 | Professional | None | $93.33 | $158.49 | $269.15 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $134.90 | Professional | 54 · Surgery only | $69.18 | $69.18 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $218.78 | Professional | None | $89.13 | $120.23 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $288.40 | Facility | None | $128.82 | $128.82 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | None | $128.82 | $128.82 | $144.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $190.55 | Professional | None | $66.07 | $114.82 | $190.55 |
13 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 $44.67 Median $54.95 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $17.78 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.60 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $10.96 | $16.98 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $11.75 | $19.05 | $27.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $117.49 Median $275.42 Typical High $346.74 | Professional | 63 · Small infant | $117.49 | $275.42 | $346.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $134.90 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $66.07 | $134.90 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $44.67 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $33.88 | Professional | 53 · Discontinued | $17.78 | $17.78 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $19.05 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $74.13 | $74.13 | $144.54 |
Where Idaho sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.