How much rates vary
Facilitymedian $363 · 10th to 90th $151 to $708Professionalmedian $550 · 10th to 90th $339 to $708
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 $436.52 Median $630.96 Typical High $4,466.84 | Facility | None | $436.52 | $630.96 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $588.84 | Professional | None | $281.84 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $251.19 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $407.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $131.83 Median $257.04 Typical High $616.60 | Facility | None | $131.83 | $257.04 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $758.58 | Professional | None | $524.81 | $602.56 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $562.34 | $616.60 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $77.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $524.81 |
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 $316.23 Median $389.05 Typical High $446.68 | Professional | None | $316.23 | $389.05 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $537.03 Typical High $758.58 | Facility | None | $251.19 | $537.03 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $691.83 | Professional | None | $363.08 | $588.84 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $251.19 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $407.38 |
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 $562.34 Median $588.84 Typical High $691.83 | Facility | None | $562.34 | $588.84 | $691.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $870.96 | Professional | None | $588.84 | $691.83 | $870.96 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $416.87 | $467.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
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 $512.86 Median $602.56 Typical High $707.95 | Professional | None | $512.86 | $602.56 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $380.19 | Facility | None | $281.84 | $331.13 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $416.87 | Professional | None | $151.36 | $331.13 | $416.87 |
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 $275.42 Median $380.19 Typical High $562.34 | Professional | None | $275.42 | $380.19 | $562.34 |
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 $169.82 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $67.61 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $58.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $758.58 Typical High $794.33 | Professional | 63 · Small infant | $630.96 | $758.58 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $269.15 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $67.61 | $107.15 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $66.07 |
Where Idaho sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.