How much rates vary
Facilitymedian $2,188 · 10th to 90th $380 to $7,762Professionalmedian $324 · 10th to 90th $224 to $398
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 $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $371.54 | Professional | None | $223.87 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $33.11 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $263.03 | $263.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $8,511.38 | Facility | None | $1,905.46 | $3,162.28 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $363.08 | Professional | None | $302.00 | $354.81 | $363.08 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $269.15 | $302.00 | $331.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $36.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $257.04 |
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 $213.80 Median $245.47 Typical High $275.42 | Professional | None | $213.80 | $245.47 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $5,495.41 | Facility | None | $223.87 | $380.19 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $436.52 | Professional | None | $223.87 | $371.54 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $33.11 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $263.03 | $263.03 |
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 $263.03 Median $323.59 Typical High $323.59 | Facility | None | $263.03 | $323.59 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $407.38 | Professional | None | $323.59 | $323.59 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $10,715.19 | Facility | None | $5,495.41 | $7,762.47 | $10,715.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $436.52 | Professional | None | $316.23 | $354.81 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $6,309.57 | Facility | None | $154.88 | $158.49 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $1,862.09 | Professional | None | $154.88 | $177.83 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $398.11 | Professional | None | $181.97 | $251.19 | $398.11 |
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 $112.20 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $44.67 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.39 | $37.15 | $37.15 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 62 · Two surgeons | $186.21 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $398.11 Typical High $436.52 | Professional | 63 · Small infant | $363.08 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $44.67 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.39 | $37.15 | $37.15 |
Where Idaho sits
The same service costs 14.2 times more in Alabama than in Montana. 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
AL $7,986MT $564
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.