How much rates vary
Facilitymedian $2,239 · 10th to 90th $933 to $8,318Professionalmedian $794 · 10th to 90th $550 to $977
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 $660.69 Median $1,071.52 Typical High $7,762.47 | Facility | None | $660.69 | $1,071.52 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $891.25 | Professional | None | $489.78 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $426.58 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $398.11 | $630.96 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $3,715.35 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,715.35 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $891.25 | Professional | None | $741.31 | $870.96 | $891.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $741.31 | $812.83 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $89.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $630.96 |
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 $524.81 Median $602.56 Typical High $691.83 | Professional | None | $524.81 | $602.56 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,148.15 Typical High $19,054.61 | Facility | None | $660.69 | $1,148.15 | $19,054.61 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,047.13 | Professional | None | $562.34 | $891.25 | $1,047.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $426.58 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $398.11 | $630.96 | $630.96 |
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 $645.65 Median $794.33 Typical High $794.33 | Facility | None | $645.65 | $794.33 | $794.33 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
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 $891.25 Typical High $1,047.13 | Professional | None | $812.83 | $891.25 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $5,248.07 | Facility | None | $380.19 | $389.05 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $1,862.09 | Professional | None | $380.19 | $446.68 | $1,862.09 |
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 $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $933.25 |
7 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 $281.84 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $281.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $114.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $56.23 | $89.13 | $89.13 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $891.25 Median $977.24 Typical High $1,071.52 | Professional | 63 · Small infant | $891.25 | $977.24 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $281.84 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $114.82 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $56.23 | $89.13 | $89.13 |
Where Idaho sits
The same service costs 5.0 times more in Wisconsin 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
WI $7,200MT $1,432
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.