How much rates vary
Facilitymedian $490 · 10th to 90th $245 to $1,622Professionalmedian $537 · 10th to 90th $389 to $832
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 $446.68 Median $1,621.81 Typical High $7,244.36 | Facility | None | $446.68 | $1,621.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $660.69 | Professional | None | $363.08 | $426.58 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $1,621.81 | Facility | None | $288.40 | $457.09 | $1,621.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,000.00 | Professional | None | $436.52 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $676.08 | Facility | None | $446.68 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $676.08 | Professional | None | $346.74 | $478.63 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $4,466.84 | Facility | None | $363.08 | $588.84 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $812.83 | Professional | None | $426.58 | $537.03 | $812.83 |
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 $416.87 Median $446.68 Typical High $794.33 | Facility | None | $416.87 | $446.68 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $933.25 | Professional | None | $446.68 | $549.54 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $812.83 | Professional | None | $436.52 | $537.03 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $691.83 | Facility | None | $436.52 | $446.68 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | None | $436.52 | $436.52 | $549.54 |
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 $309.03 Median $467.74 Typical High $707.95 | Professional | None | $309.03 | $467.74 | $707.95 |
19 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 $213.80 Typical High $331.13 | Professional | 52 · Reduced service | $213.80 | $213.80 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $457.09 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $630.96 Typical High $851.14 | Professional | 54 · Surgery only | $426.58 | $630.96 | $851.14 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $56.23 Typical High $102.33 | Professional | 55 · Aftercare only | $46.77 | $56.23 | $102.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $562.34 Median $588.84 Typical High $1,230.27 | Professional | 63 · Small infant | $562.34 | $588.84 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $512.86 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $213.80 Typical High $331.13 | Professional | 52 · Reduced service | $213.80 | $213.80 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 53 · Discontinued | $85.11 | $85.11 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $316.23 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $331.13 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $549.54 |
Where Idaho sits
The same service costs 4.1 times more in New York 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
NY $3,010MD $740
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.