How much rates vary
Facilitymedian $195 · 10th to 90th $107 to $708Professionalmedian $191 · 10th to 90th $126 to $288
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 $117.49 Median $190.55 Typical High $251.19 | Professional | None | $117.49 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $89.13 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $131.83 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $83.18 | $131.83 | $173.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $107.15 Median $245.47 Typical High $707.95 | Facility | None | $107.15 | $245.47 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $309.03 | Professional | None | $177.83 | $218.78 | $309.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $194.98 | $275.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $29.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $165.96 | Facility | None | $109.65 | $123.03 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $190.55 | Professional | None | $117.49 | $144.54 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $251.19 Typical High $5,495.41 | Facility | None | $104.71 | $251.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $302.00 | Professional | None | $158.49 | $223.87 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $89.13 | $141.25 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $131.83 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $83.18 | $131.83 | $173.78 |
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 $194.98 Median $194.98 Typical High $288.40 | Facility | None | $194.98 | $194.98 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $363.08 | Professional | None | $194.98 | $245.47 | $363.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $147.91 | $194.98 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $208.93 |
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 $190.55 Median $223.87 Typical High $302.00 | Professional | None | $190.55 | $223.87 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $338.84 | Facility | None | $138.04 | $141.25 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $162.18 | Professional | None | $95.50 | $138.04 | $162.18 |
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 $100.00 Median $141.25 Typical High $229.09 | Professional | None | $100.00 | $141.25 | $229.09 |
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 $58.88 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $23.44 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $25.12 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $213.80 Median $316.23 Typical High $389.05 | Professional | 63 · Small infant | $213.80 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $95.50 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $23.44 | $38.02 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $25.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $28.18 |
Where Idaho sits
The same service costs 13.1 times more in Hawaii 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
HI $2,944MD $224
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.