How much rates vary
Facilitymedian $1,000 · 10th to 90th $575 to $4,266Professionalmedian $955 · 10th to 90th $617 to $1,175
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 $776.25 Median $4,466.84 Typical High $7,244.36 | Facility | None | $776.25 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $1,071.52 | Professional | None | $537.03 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $512.86 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $4,265.80 | Facility | None | $1,000.00 | $1,862.09 | $4,265.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,071.52 | Professional | None | $870.96 | $1,023.29 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $891.25 | $954.99 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $107.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $831.76 | Professional | None | $616.60 | $724.44 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $5,495.41 | Facility | None | $524.81 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,258.93 | Professional | None | $676.08 | $1,071.52 | $1,258.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $512.86 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $741.31 |
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 $776.25 Median $954.99 Typical High $954.99 | Facility | None | $776.25 | $954.99 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $3,715.35 | Facility | None | $457.09 | $467.74 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $831.76 | Professional | None | $457.09 | $537.03 | $831.76 |
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 $549.54 Median $758.58 Typical High $1,122.02 | Professional | None | $549.54 | $758.58 | $1,122.02 |
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 $338.84 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $67.61 | $107.15 | $107.15 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | 63 · Small infant | $1,047.13 | $1,174.90 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $134.90 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $67.61 | $107.15 | $107.15 |
Where Idaho sits
The same service costs 4.0 times more in Colorado 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
CO $5,106MD $1,261
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.