How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,512 to $17,378Professionalmedian $1,148 · 10th to 90th $661 to $12,023
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,348.96 Typical High $12,022.64 | Professional | None | $602.56 | $1,348.96 | $12,022.64 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $4,073.80 Typical High $9,120.11 | Professional | 54 · Surgery only | $446.68 | $4,073.80 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $831.76 Typical High $1,819.70 | Professional | 55 · Aftercare only | $89.13 | $831.76 | $1,819.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $3,801.89 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $416.87 | $3,801.89 | $8,511.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,897.79 Median $8,709.64 Typical High $18,620.87 | Facility | None | $4,897.79 | $8,709.64 | $18,620.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $8,511.38 Typical High $12,302.69 | Professional | None | $776.25 | $8,511.38 | $12,302.69 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $10,471.29 | Professional | 54 · Surgery only | $676.08 | $794.33 | $10,471.29 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $1,000.00 Typical High $1,230.27 | Professional | 55 · Aftercare only | $75.86 | $1,000.00 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $645.65 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $524.81 | $645.65 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,073.80 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $10,232.93 | Professional | None | $660.69 | $891.25 | $10,232.93 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $12,022.64 | Facility | None | $602.56 | $4,466.84 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $12,022.64 | Professional | None | $707.95 | $1,659.59 | $12,022.64 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $724.44 Typical High $9,120.11 | Professional | 54 · Surgery only | $446.68 | $724.44 | $9,120.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $144.54 Typical High $1,819.70 | Professional | 55 · Aftercare only | $89.13 | $144.54 | $1,819.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $676.08 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $416.87 | $676.08 | $8,511.38 |
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 $812.83 Median $812.83 Typical High $11,220.18 | Facility | None | $812.83 | $812.83 | $11,220.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $2,238.72 Typical High $14,125.38 | Professional | None | $812.83 | $2,238.72 | $14,125.38 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $8,511.38 | Professional | 54 · Surgery only | $724.44 | $724.44 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $9,120.11 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $17,378.01 Typical High $23,442.29 | Facility | None | $12,022.64 | $17,378.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $2,884.03 Typical High $13,803.84 | Professional | None | $954.99 | $2,884.03 | $13,803.84 |
Select Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $13,489.63 | Facility | None | $5,370.32 | $5,495.41 | $13,489.63 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $4,168.69 Typical High $6,760.83 | Professional | None | $467.74 | $4,168.69 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $524.81 Median $5,495.41 Typical High $12,882.50 | Professional | None | $524.81 | $5,495.41 | $12,882.50 |
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 $295.12 Median $2,754.23 Typical High $6,025.60 | Professional | 52 · Reduced service | $295.12 | $2,754.23 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $1,096.48 Typical High $2,398.83 | Professional | 53 · Discontinued | $120.23 | $1,096.48 | $2,398.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $549.54 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $60.26 | $549.54 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $912.01 Median $12,022.64 Typical High $14,454.40 | Professional | 63 · Small infant | $912.01 | $12,022.64 | $14,454.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $478.63 Typical High $6,025.60 | Professional | 52 · Reduced service | $295.12 | $478.63 | $6,025.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $194.98 Typical High $2,398.83 | Professional | 53 · Discontinued | $120.23 | $194.98 | $2,398.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $97.72 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $60.26 | $97.72 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $1,230.27 |
Where Idaho sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,466
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.