How much rates vary
Facilitymedian $1,698 · 10th to 90th $575 to $6,607Professionalmedian $1,000 · 10th to 90th $661 to $1,202
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 $562.34 Median $1,096.48 Typical High $1,096.48 | Professional | None | $562.34 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $7,413.10 | Facility | None | $1,230.27 | $2,398.83 | $7,413.10 |
BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,122.02 | Professional | None | $933.25 | $1,096.48 | $1,122.02 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,000.00 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $112.20 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $724.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $851.14 | Professional | None | $645.65 | $741.31 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $5,495.41 | Facility | None | $616.60 | $1,096.48 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,288.25 | Professional | None | $691.83 | $1,096.48 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
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 $1,000.00 Typical High $1,000.00 | Facility | None | $812.83 | $1,000.00 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,000.00 | $1,258.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | None | $977.24 | $1,096.48 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $489.78 Typical High $2,818.38 | Facility | None | $478.63 | $489.78 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $1,412.54 | Professional | None | $478.63 | $549.54 | $1,412.54 |
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 $575.44 Median $776.25 Typical High $1,148.15 | Professional | None | $575.44 | $776.25 | $1,148.15 |
9 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 $346.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $69.18 | $109.65 | $109.65 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,311.31 Typical High $11,220.18 | Facility | 50 · Both sides | $1,778.28 | $3,311.31 | $11,220.18 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | 50 · Both sides | $1,380.38 | $1,548.82 | $1,698.24 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,096.48 Median $1,230.27 Typical High $1,348.96 | Professional | 63 · Small infant | $1,096.48 | $1,230.27 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $69.18 | $109.65 | $109.65 |
Where Idaho sits
The same service costs 4.6 times more in Colorado than in Delaware. 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
CO $6,382DE $1,376
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.