How much rates vary
Facilitymedian $1,380 · 10th to 90th $339 to $4,786Professionalmedian $427 · 10th to 90th $309 to $661
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 $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | None | $288.40 | $338.84 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $257.04 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $416.87 Median $1,380.38 Typical High $4,897.79 | Facility | None | $416.87 | $1,380.38 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $758.58 | Professional | None | $338.84 | $446.68 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $676.08 | Professional | 54 · Surgery only | $309.03 | $354.81 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $537.03 | Professional | None | $295.12 | $380.19 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $5,495.41 | Facility | None | $281.84 | $489.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $660.69 | Professional | None | $323.59 | $426.58 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $257.04 | $398.11 |
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 $309.03 Median $323.59 Typical High $602.56 | Facility | None | $309.03 | $323.59 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $691.83 | Professional | None | $323.59 | $416.87 | $691.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $257.04 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $660.69 | Professional | None | $338.84 | $426.58 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Facility | None | $331.13 | $331.13 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $537.03 | Professional | None | $245.47 | $363.08 | $537.03 |
15 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 $169.82 Median $169.82 Typical High $263.03 | Professional | 52 · Reduced service | $169.82 | $169.82 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $52.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $51.29 Typical High $75.86 | Professional | 55 · Aftercare only | $35.48 | $51.29 | $75.86 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $257.04 Typical High $489.78 | Professional | 62 · Two surgeons | $229.09 | $257.04 | $489.78 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $512.86 Median $776.25 Typical High $912.01 | Professional | 63 · Small infant | $512.86 | $776.25 | $912.01 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | 52 · Reduced service | $169.82 | $169.82 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $67.61 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $234.42 Typical High $354.81 | Professional | 62 · Two surgeons | $234.42 | $234.42 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $426.58 |
Where Idaho sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.