How much rates vary
Facilitymedian $933 · 10th to 90th $550 to $3,090Professionalmedian $537 · 10th to 90th $257 to $1,288
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 $251.19 Median $537.03 Typical High $1,659.59 | Professional | None | $251.19 | $537.03 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $407.38 Typical High $1,258.93 | Professional | 54 · Surgery only | $186.21 | $407.38 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $81.28 Typical High $251.19 | Professional | 55 · Aftercare only | $37.15 | $81.28 | $251.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $3,548.13 | Facility | None | $891.25 | $1,174.90 | $3,548.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $309.03 Median $812.83 Typical High $1,288.25 | Professional | None | $309.03 | $812.83 | $1,288.25 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $269.15 | $977.24 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $128.82 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Facility | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $912.01 | Professional | None | $257.04 | $380.19 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $5,495.41 | Facility | None | $251.19 | $870.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,659.59 | Professional | None | $269.15 | $537.03 | $1,659.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $407.38 Typical High $1,258.93 | Professional | 54 · Surgery only | $186.21 | $407.38 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $81.28 Typical High $251.19 | Professional | 55 · Aftercare only | $37.15 | $81.28 | $251.19 |
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 $323.59 Median $323.59 Typical High $1,202.26 | Facility | None | $323.59 | $323.59 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $1,202.26 | Professional | None | $323.59 | $562.34 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $758.58 | Professional | 54 · Surgery only | $251.19 | $398.11 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Facility | None | $1,995.26 | $2,630.27 | $3,890.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $1,096.48 | Professional | None | $346.74 | $457.09 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Facility | None | $562.34 | $562.34 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $562.34 Typical High $676.08 | Professional | None | $199.53 | $562.34 | $676.08 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $199.53 Median $478.63 Typical High $1,023.29 | Professional | None | $199.53 | $478.63 | $1,023.29 |
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 $123.03 Median $269.15 Typical High $831.76 | Professional | 52 · Reduced service | $123.03 | $269.15 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $107.15 Typical High $331.13 | Professional | 53 · Discontinued | $50.12 | $107.15 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $53.70 Typical High $165.96 | Professional | 56 · Pre-op care only | $25.12 | $53.70 | $165.96 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $354.81 Median $416.87 Typical High $1,621.81 | Professional | 63 · Small infant | $354.81 | $416.87 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $269.15 Typical High $831.76 | Professional | 52 · Reduced service | $123.03 | $269.15 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $107.15 Typical High $331.13 | Professional | 53 · Discontinued | $50.12 | $107.15 | $331.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $53.70 Typical High $165.96 | Professional | 56 · Pre-op care only | $25.12 | $53.70 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $56.23 Typical High $107.15 | Professional | 56 · Pre-op care only | $35.48 | $56.23 | $107.15 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $426.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $269.15 | $426.58 | $812.83 |
Where Idaho sits
The same service costs 4.8 times more in Colorado 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
CO $4,327MD $911
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.