How much rates vary
Facilitymedian $269 · 10th to 90th $145 to $741Professionalmedian $107 · 10th to 90th $52 to $575
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 $64.57 Median $812.83 Typical High $7,079.46 | Facility | None | $64.57 | $812.83 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $204.17 Typical High $676.08 | Professional | None | $38.90 | $204.17 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $158.49 Typical High $501.19 | Professional | 54 · Surgery only | $38.02 | $158.49 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $31.62 Typical High $100.00 | Professional | 55 · Aftercare only | $7.59 | $31.62 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $741.31 | Facility | None | $177.83 | $323.59 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $63.10 Median $363.08 Typical High $575.44 | Professional | None | $63.10 | $363.08 | $575.44 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $363.08 Typical High $524.81 | Professional | 54 · Surgery only | $54.95 | $363.08 | $524.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $6.76 | $45.71 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $229.09 | Facility | None | $151.36 | $169.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $181.97 Typical High $371.54 | Professional | None | $52.48 | $181.97 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $467.74 Typical High $4,466.84 | Facility | None | $64.57 | $467.74 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $208.93 Typical High $676.08 | Professional | None | $50.12 | $208.93 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $151.36 Typical High $501.19 | Professional | 54 · Surgery only | $38.02 | $151.36 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $30.20 Typical High $100.00 | Professional | 55 · Aftercare only | $7.59 | $30.20 | $100.00 |
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 $66.07 Median $66.07 Typical High $524.81 | Facility | None | $66.07 | $66.07 | $524.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $524.81 | Professional | None | $66.07 | $114.82 | $524.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $79.43 Typical High $302.00 | Professional | 54 · Surgery only | $50.12 | $79.43 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $812.83 | Facility | None | $467.74 | $602.56 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $446.68 | Professional | None | $70.79 | $93.33 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Facility | None | $251.19 | $251.19 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $251.19 Typical High $275.42 | Professional | None | $41.69 | $251.19 | $275.42 |
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 $41.69 Median $186.21 Typical High $398.11 | Professional | None | $41.69 | $186.21 | $398.11 |
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 $25.12 Median $104.71 Typical High $338.84 | Professional | 52 · Reduced service | $25.12 | $104.71 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $42.66 Typical High $134.90 | Professional | 53 · Discontinued | $10.00 | $42.66 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $20.89 Typical High $67.61 | Professional | 56 · Pre-op care only | $5.01 | $20.89 | $67.61 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $72.44 Median $89.13 Typical High $645.65 | Professional | 63 · Small infant | $72.44 | $89.13 | $645.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $50.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $42.66 | $50.12 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $102.33 Typical High $338.84 | Professional | 52 · Reduced service | $25.12 | $102.33 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $40.74 Typical High $134.90 | Professional | 53 · Discontinued | $10.00 | $40.74 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $20.89 Typical High $67.61 | Professional | 56 · Pre-op care only | $5.01 | $20.89 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $7.24 | $11.48 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $85.11 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $53.70 | $85.11 | $323.59 |
Where Idaho sits
The same service costs 12.1 times more in New York 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
NY $2,679MD $222
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.