How much rates vary
Facilitymedian $302 · 10th to 90th $166 to $1,202Professionalmedian $251 · 10th to 90th $182 to $372
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 $213.80 Median $1,621.81 Typical High $7,244.36 | Facility | None | $213.80 | $1,621.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $295.12 | Professional | None | $162.18 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $147.91 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $302.00 Typical High $1,202.26 | Facility | None | $141.25 | $302.00 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $446.68 | Professional | None | $204.17 | $263.03 | $446.68 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $199.53 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $371.54 | Facility | None | $245.47 | $275.42 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | None | $162.18 | $213.80 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $4,466.84 | Facility | None | $147.91 | $257.04 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $371.54 | Professional | None | $199.53 | $251.19 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $147.91 | $223.87 |
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 $199.53 Typical High $354.81 | Facility | None | $190.55 | $199.53 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $416.87 | Professional | None | $199.53 | $245.47 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $234.42 | Professional | 54 · Surgery only | $154.88 | $154.88 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,318.26 | Facility | None | $676.08 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $371.54 | Professional | None | $204.17 | $251.19 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $416.87 | Facility | None | $194.98 | $199.53 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | None | $194.98 | $194.98 | $251.19 |
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 $144.54 Median $208.93 Typical High $309.03 | Professional | None | $144.54 | $208.93 | $309.03 |
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 $100.00 Median $100.00 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $29.51 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $21.88 | $38.02 | $45.71 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $251.19 Median $380.19 Typical High $549.54 | Professional | 63 · Small infant | $251.19 | $380.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | 52 · Reduced service | $100.00 | $100.00 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $39.81 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $251.19 |
Where Idaho sits
The same service costs 7.3 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 $2,792MD $382
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.