How much rates vary
Facilitymedian $324 · 10th to 90th $151 to $708Professionalmedian $589 · 10th to 90th $380 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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $630.96 | Professional | None | $331.13 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $407.38 | $446.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $707.95 | Facility | None | $144.54 | $263.03 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $741.31 | Professional | None | $524.81 | $616.60 | $741.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $478.63 | $588.84 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $512.86 |
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 $338.84 Median $426.58 Typical High $478.63 | Professional | None | $338.84 | $426.58 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $5,495.41 | Facility | None | $288.40 | $630.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $724.44 | Professional | None | $416.87 | $588.84 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $436.52 | $478.63 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $407.38 | $446.68 |
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 $549.54 Median $575.44 Typical High $676.08 | Facility | None | $549.54 | $575.44 | $676.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $457.09 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $524.81 |
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 $549.54 Median $645.65 Typical High $758.58 | Professional | None | $549.54 | $645.65 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $323.59 Typical High $338.84 | Facility | None | $281.84 | $323.59 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $457.09 | Professional | None | $151.36 | $323.59 | $457.09 |
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 $302.00 Median $416.87 Typical High $616.60 | Professional | None | $302.00 | $416.87 | $616.60 |
14 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 $190.55 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $190.55 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $75.86 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $63.10 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $218.78 Median $380.19 Typical High $1,071.52 | Facility | 50 · Both sides | $218.78 | $380.19 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,096.48 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $75.86 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $630.96 Median $776.25 Typical High $912.01 | Professional | 63 · Small infant | $630.96 | $776.25 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $190.55 | $295.12 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $75.86 | $117.49 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $87.10 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $63.10 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Professional | 50 · Both sides | $977.24 | $977.24 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $70.79 |
Where Idaho sits
The same service costs 6.5 times more in Connecticut 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
CT $3,149MD $483
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.