How much rates vary
Facilitymedian $339 · 10th to 90th $158 to $776Professionalmedian $776 · 10th to 90th $457 to $933
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 $630.96 Median $4,466.84 Typical High $7,079.46 | Facility | None | $630.96 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | None | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $549.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $616.60 | Facility | None | $181.97 | $302.00 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $933.25 | Professional | None | $707.95 | $831.76 | $933.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $89.13 | $97.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $630.96 | $676.08 |
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 $426.58 Median $524.81 Typical High $588.84 | Professional | None | $426.58 | $524.81 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $630.96 Typical High $5,495.41 | Facility | None | $416.87 | $630.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $933.25 | Professional | None | $489.78 | $776.25 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $549.54 |
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 $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 $676.08 Median $794.33 Typical High $933.25 | Professional | None | $676.08 | $794.33 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $416.87 Typical High $416.87 | Facility | None | $281.84 | $416.87 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $416.87 Typical High $602.56 | Professional | None | $151.36 | $416.87 | $602.56 |
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 $389.05 Median $537.03 Typical High $776.25 | Professional | None | $389.05 | $537.03 | $776.25 |
9 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 $245.47 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $97.72 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $77.62 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $269.15 Median $446.68 Typical High $912.01 | Facility | 50 · Both sides | $269.15 | $446.68 | $912.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,318.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,071.52 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $851.14 Median $1,071.52 Typical High $1,174.90 | Professional | 63 · Small infant | $851.14 | $1,071.52 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $245.47 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $97.72 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $77.62 |
Where Idaho sits
The same service costs 6.4 times more in Connecticut than in Texas. 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 $3,322TX $515
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.