How much rates vary
Facilitymedian $2,188 · 10th to 90th $871 to $7,762Professionalmedian $871 · 10th to 90th $562 to $1,072
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 $724.44 Median $4,168.69 Typical High $6,918.31 | Facility | None | $724.44 | $4,168.69 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $977.24 | Professional | None | $501.19 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $676.08 |
BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $8,511.38 | Facility | None | $1,995.26 | $3,548.13 | $8,511.38 |
BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $977.24 | Professional | None | $812.83 | $954.99 | $977.24 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $812.83 | $891.25 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $97.72 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $691.83 |
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 $549.54 Median $660.69 Typical High $741.31 | Professional | None | $549.54 | $660.69 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,148.15 Typical High $17,782.79 | Facility | None | $616.60 | $1,148.15 | $17,782.79 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,148.15 | Professional | None | $616.60 | $977.24 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $676.08 |
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 $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 $870.96 Median $977.24 Typical High $1,148.15 | Professional | None | $870.96 | $977.24 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $5,370.32 | Facility | None | $416.87 | $426.58 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $1,862.09 | Professional | None | $416.87 | $489.78 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $954.99 | Professional | None | $489.78 | $676.08 | $954.99 |
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 $309.03 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $97.72 | $97.72 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $977.24 Median $1,096.48 Typical High $1,174.90 | Professional | 63 · Small infant | $977.24 | $1,096.48 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $309.03 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $61.66 | $97.72 | $97.72 |
Where Idaho sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.