How much rates vary
Facilitymedian $575 · 10th to 90th $170 to $3,981Professionalmedian $692 · 10th to 90th $200 to $1,585
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 $162.18 Median $812.83 Typical High $2,454.71 | Professional | None | $162.18 | $812.83 | $2,454.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $3,981.07 | Facility | None | $575.44 | $1,348.96 | $3,981.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $1,584.89 | Professional | None | $234.42 | $316.23 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $426.58 Typical High $1,380.38 | Professional | None | $208.93 | $426.58 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $691.83 Typical High $5,495.41 | Facility | None | $165.96 | $691.83 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $891.25 Typical High $2,454.71 | Professional | None | $213.80 | $891.25 | $2,454.71 |
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 $251.19 Median $251.19 Typical High $1,445.44 | Facility | None | $251.19 | $251.19 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $1,445.44 | Professional | None | $251.19 | $275.42 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $1,548.82 | Professional | None | $288.40 | $316.23 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $4,466.84 | Facility | None | $691.83 | $707.95 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $691.83 Typical High $933.25 | Professional | None | $158.49 | $691.83 | $933.25 |
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 $165.96 Median $691.83 Typical High $1,621.81 | Professional | None | $165.96 | $691.83 | $1,621.81 |
15 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 $95.50 Median $229.09 Typical High $1,230.27 | Professional | 52 · Reduced service | $95.50 | $229.09 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $91.20 Typical High $489.78 | Professional | 53 · Discontinued | $38.02 | $91.20 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $346.74 Typical High $1,862.09 | Professional | 54 · Surgery only | $141.25 | $346.74 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $69.18 Typical High $371.54 | Professional | 55 · Aftercare only | $28.18 | $69.18 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $45.71 Typical High $245.47 | Professional | 56 · Pre-op care only | $19.05 | $45.71 | $245.47 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $1,949.84 Typical High $2,344.23 | Professional | 50 · Both sides | $354.81 | $1,949.84 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,174.90 Typical High $1,479.11 | Professional | 54 · Surgery only | $208.93 | $1,174.90 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $154.88 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $154.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $331.13 Typical High $1,905.46 | Professional | 63 · Small infant | $281.84 | $331.13 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $199.53 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $158.49 | $199.53 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $229.09 Typical High $1,230.27 | Professional | 52 · Reduced service | $100.00 | $229.09 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $91.20 Typical High $489.78 | Professional | 53 · Discontinued | $39.81 | $91.20 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $346.74 Typical High $1,862.09 | Professional | 54 · Surgery only | $147.91 | $346.74 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $69.18 Typical High $371.54 | Professional | 55 · Aftercare only | $30.20 | $69.18 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $45.71 Typical High $245.47 | Professional | 56 · Pre-op care only | $19.95 | $45.71 | $245.47 |
Where Idaho sits
The same service costs 9.9 times more in New York than in Kentucky. 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
NY $4,974KY $504
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.