How much rates vary
Facilitymedian $302 · 10th to 90th $155 to $708Professionalmedian $575 · 10th to 90th $363 to $724
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $660.69 | Professional | None | $346.74 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $269.15 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $251.19 | $398.11 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $616.60 | Facility | None | $158.49 | $263.03 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $741.31 | Professional | 54 · Surgery only | $457.09 | $562.34 | $741.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $79.43 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $575.44 |
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 $346.74 Median $436.52 Typical High $501.19 | Professional | None | $346.74 | $436.52 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $4,466.84 | Facility | None | $288.40 | $562.34 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $724.44 | Professional | None | $426.58 | $630.96 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $269.15 | $426.58 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $251.19 | $398.11 | $457.09 |
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 $575.44 Median $575.44 Typical High $724.44 | Facility | None | $575.44 | $575.44 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $912.01 | Professional | None | $575.44 | $724.44 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $436.52 | $512.86 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $549.54 |
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 $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $363.08 | Facility | None | $281.84 | $346.74 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $436.52 | Professional | None | $151.36 | $346.74 | $436.52 |
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 $295.12 Median $416.87 Typical High $616.60 | Professional | None | $295.12 | $416.87 | $616.60 |
8 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 $181.97 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $181.97 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $72.44 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $66.07 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $616.60 Median $812.83 Typical High $954.99 | Professional | 63 · Small infant | $616.60 | $812.83 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $181.97 | $281.84 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $72.44 | $112.20 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Where Idaho sits
The same service costs 6.7 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 $2,828FL $419
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.