How much rates vary
Facilitymedian $363 · 10th to 90th $155 to $1,047Professionalmedian $933 · 10th to 90th $603 to $1,122
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 $1,122.02 Median $1,202.26 Typical High $5,495.41 | Facility | None | $1,122.02 | $1,202.26 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,023.29 | Professional | None | $524.81 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $446.68 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $616.60 | Facility | None | $154.88 | $257.04 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,148.15 | Professional | None | $812.83 | $954.99 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $724.44 | $870.96 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $114.82 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $114.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $229.09 | Facility | None | $147.91 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $776.25 | Professional | None | $549.54 | $691.83 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,445.44 | Facility | None | $512.86 | $933.25 | $1,445.44 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,122.02 | Professional | None | $660.69 | $933.25 | $1,122.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $446.68 | $707.95 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $707.95 |
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 $851.14 Median $870.96 Typical High $1,047.13 | Facility | None | $851.14 | $870.96 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | None | $870.96 | $1,047.13 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $776.25 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,202.26 | Professional | None | $870.96 | $1,023.29 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $512.86 | Facility | None | $302.00 | $501.19 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $724.44 | Professional | None | $151.36 | $501.19 | $724.44 |
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 $489.78 Median $676.08 Typical High $977.24 | Professional | None | $489.78 | $676.08 | $977.24 |
11 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 $302.00 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $302.00 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $120.23 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $102.33 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $239.88 Median $371.54 Typical High $912.01 | Facility | 50 · Both sides | $239.88 | $371.54 | $912.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | 50 · Both sides | $1,202.26 | $1,479.11 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | 63 · Small infant | $954.99 | $1,122.02 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $302.00 | $467.74 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $120.23 | $186.21 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | 50 · Both sides | $1,548.82 | $1,548.82 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $112.20 |
Where Idaho sits
The same service costs 4.7 times more in New York than in Florida. 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 $3,038FL $649
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.