How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,413 to $8,318Professionalmedian $977 · 10th to 90th $562 to $3,802
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 $3,388.44 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,388.44 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $1,348.96 Typical High $3,801.89 | Professional | None | $501.19 | $1,348.96 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $1,288.25 Typical High $2,884.03 | Professional | 54 · Surgery only | $380.19 | $1,288.25 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $257.04 Typical High $575.44 | Professional | 55 · Aftercare only | $75.86 | $257.04 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $1,202.26 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $354.81 | $1,202.26 | $2,691.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,467.37 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $676.08 Median $2,630.27 Typical High $3,715.35 | Professional | None | $676.08 | $2,630.27 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $3,388.44 | Professional | 54 · Surgery only | $602.56 | $707.95 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $263.03 Typical High $371.54 | Professional | 55 · Aftercare only | $67.61 | $263.03 | $371.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $630.96 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $457.09 | $630.96 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,819.70 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $2,951.21 | Professional | None | $562.34 | $776.25 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $2,630.27 Typical High $5,495.41 | Facility | None | $501.19 | $2,630.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $1,348.96 Typical High $3,801.89 | Professional | None | $602.56 | $1,348.96 | $3,801.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $630.96 Typical High $2,884.03 | Professional | 54 · Surgery only | $380.19 | $630.96 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $125.89 Typical High $575.44 | Professional | 55 · Aftercare only | $75.86 | $125.89 | $575.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $588.84 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $354.81 | $588.84 | $2,691.53 |
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 $707.95 Median $707.95 Typical High $3,388.44 | Facility | None | $707.95 | $707.95 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $4,365.16 | Professional | None | $707.95 | $891.25 | $4,365.16 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,754.23 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $4,365.16 | Professional | None | $812.83 | $1,288.25 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $5,248.07 | Facility | None | $1,621.81 | $1,659.59 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $1,621.81 Typical High $2,187.76 | Professional | None | $407.38 | $1,621.81 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,479.11 Typical High $3,311.31 | Professional | None | $446.68 | $1,479.11 | $3,311.31 |
8 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 $251.19 Median $851.14 Typical High $1,905.46 | Professional | 52 · Reduced service | $251.19 | $851.14 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $346.74 Typical High $758.58 | Professional | 53 · Discontinued | $100.00 | $346.74 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $169.82 Typical High $380.19 | Professional | 56 · Pre-op care only | $50.12 | $169.82 | $380.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $776.25 Median $3,801.89 Typical High $4,570.88 | Professional | 63 · Small infant | $776.25 | $3,801.89 | $4,570.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $416.87 Typical High $1,905.46 | Professional | 52 · Reduced service | $251.19 | $416.87 | $1,905.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $165.96 Typical High $758.58 | Professional | 53 · Discontinued | $100.00 | $165.96 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $83.18 Typical High $380.19 | Professional | 56 · Pre-op care only | $50.12 | $83.18 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $389.05 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $389.05 |
Where Idaho sits
The same service costs 4.4 times more in Oklahoma 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
OK $10,373MD $2,367
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.