How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,148 to $10,965Professionalmedian $1,148 · 10th to 90th $813 to $1,413
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 $691.83 Median $1,318.26 Typical High $1,318.26 | Professional | None | $691.83 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,398.83 | $6,309.57 | $12,022.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,230.27 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,148.15 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $128.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $891.25 |
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 $776.25 Median $891.25 Typical High $1,000.00 | Professional | None | $776.25 | $891.25 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $5,495.41 | Facility | None | $549.54 | $1,318.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,513.56 | Professional | None | $812.83 | $1,318.26 | $1,513.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $616.60 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $123.03 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $912.01 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $12,589.25 | Facility | None | $7,585.78 | $10,000.00 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,288.25 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $4,073.80 | Facility | None | $549.54 | $549.54 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,862.09 | Professional | None | $549.54 | $630.96 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,412.54 | Professional | None | $724.44 | $977.24 | $1,412.54 |
10 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 $407.38 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $407.38 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $162.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $131.83 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $9,332.54 Typical High $18,197.01 | Facility | 50 · Both sides | $3,630.78 | $9,332.54 | $18,197.01 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,778.28 Typical High $1,905.46 | Professional | 50 · Both sides | $1,584.89 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $741.31 Typical High $794.33 | Professional | 62 · Two surgeons | $660.69 | $741.31 | $794.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | 63 · Small infant | $1,258.93 | $1,412.54 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $407.38 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $162.18 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $131.83 |
Where Idaho sits
The same service costs 7.6 times more in Oklahoma 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
OK $11,248TX $1,472
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.