How much rates vary
Facilitymedian $1,175 · 10th to 90th $575 to $4,467Professionalmedian $871 · 10th to 90th $537 to $1,000
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $933.25 | Professional | None | $602.56 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $446.68 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $4,365.16 | Facility | None | $1,174.90 | $1,905.46 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $977.24 | Professional | None | $776.25 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,445.44 | Facility | None | $954.99 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $691.83 | Professional | None | $489.78 | $616.60 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $933.25 Typical High $5,495.41 | Facility | None | $478.63 | $933.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,096.48 | Professional | None | $602.56 | $933.25 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $446.68 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $416.87 | $660.69 | $660.69 |
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 $707.95 Median $870.96 Typical High $870.96 | Facility | None | $707.95 | $870.96 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | None | $870.96 | $870.96 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,248.07 | Facility | None | $2,691.53 | $3,890.45 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $3,801.89 | Facility | None | $416.87 | $416.87 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $977.24 | Professional | None | $416.87 | $446.68 | $977.24 |
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 $416.87 Median $575.44 Typical High $831.76 | Professional | None | $416.87 | $575.44 | $831.76 |
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 $302.00 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $302.00 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $120.23 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $93.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 63 · Small infant | $954.99 | $1,071.52 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $302.00 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $120.23 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $93.33 |
Where Idaho sits
The same service costs 4.2 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 $4,996DE $1,192
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.