How much rates vary
Facilitymedian $3,802 · 10th to 90th $933 to $8,913Professionalmedian $617 · 10th to 90th $398 to $977
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 $398.11 Median $977.24 Typical High $977.24 | Professional | None | $398.11 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $302.00 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $147.91 | $147.91 |
BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $8,912.51 | Facility | None | $2,089.30 | $3,467.37 | $8,912.51 |
BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $660.69 | Professional | None | $549.54 | $645.65 | $660.69 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $562.34 | $602.56 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $5,248.07 Typical High $7,079.46 | Facility | None | $4,677.35 | $5,248.07 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $562.34 | Professional | None | $389.05 | $478.63 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $977.24 Typical High $5,495.41 | Facility | None | $426.58 | $977.24 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $977.24 | Professional | None | $426.58 | $630.96 | $977.24 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $323.59 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $64.57 | $147.91 | $147.91 |
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 $478.63 Median $588.84 Typical High $588.84 | Facility | None | $478.63 | $588.84 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | None | $588.84 | $588.84 | $645.65 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $8,912.51 Typical High $11,220.18 | Facility | None | $6,165.95 | $8,912.51 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | None | $549.54 | $645.65 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $5,370.32 | Facility | None | $281.84 | $288.40 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $616.60 | Professional | None | $281.84 | $281.84 | $616.60 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $741.31 | Professional | None | $363.08 | $489.78 | $741.31 |
12 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 $199.53 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $199.53 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $79.43 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $39.81 | $97.72 | $97.72 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $758.58 Typical High $794.33 | Professional | 63 · Small infant | $660.69 | $758.58 | $794.33 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $213.80 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $85.11 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $42.66 | $97.72 | $97.72 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 22 · Increased work | $707.95 | $707.95 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 63 · Small infant | $707.95 | $707.95 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where Idaho sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.