How much rates vary
Facilitymedian $1,122 · 10th to 90th $355 to $4,898Professionalmedian $398 · 10th to 90th $166 to $2,512
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 $416.87 Median $2,290.87 Typical High $5,495.41 | Facility | None | $416.87 | $2,290.87 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $1,000.00 Typical High $3,801.89 | Professional | None | $158.49 | $1,000.00 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $758.58 Typical High $2,884.03 | Professional | 54 · Surgery only | $120.23 | $758.58 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $151.36 Typical High $575.44 | Professional | 55 · Aftercare only | $23.99 | $151.36 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $2,454.71 Typical High $4,897.79 | Facility | None | $446.68 | $2,454.71 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $1,584.89 Typical High $2,511.89 | Professional | None | $199.53 | $1,584.89 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $1,949.84 Typical High $2,290.87 | Professional | 54 · Surgery only | $190.55 | $1,949.84 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $239.88 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Facility | None | $812.83 | $912.01 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $1,995.26 | Professional | None | $165.96 | $389.05 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $3,311.31 Typical High $7,244.36 | Facility | None | $346.74 | $3,311.31 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $1,000.00 Typical High $3,801.89 | Professional | None | $173.78 | $1,000.00 | $3,801.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $489.78 Typical High $2,884.03 | Professional | 54 · Surgery only | $120.23 | $489.78 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $97.72 Typical High $575.44 | Professional | 55 · Aftercare only | $23.99 | $97.72 | $575.44 |
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 $204.17 Median $204.17 Typical High $2,344.23 | Facility | None | $204.17 | $204.17 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $2,398.83 | Professional | None | $204.17 | $467.74 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $1,659.59 | Professional | 54 · Surgery only | $162.18 | $257.04 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $5,248.07 | Facility | None | $1,737.80 | $3,630.78 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $2,454.71 | Professional | None | $229.09 | $295.12 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,122.02 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $1,122.02 Typical High $1,513.56 | Professional | None | $128.82 | $1,122.02 | $1,513.56 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $131.83 Median $933.25 Typical High $1,949.84 | Professional | None | $131.83 | $933.25 | $1,949.84 |
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 $79.43 Median $501.19 Typical High $1,905.46 | Professional | 52 · Reduced service | $79.43 | $501.19 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $199.53 Typical High $758.58 | Professional | 53 · Discontinued | $31.62 | $199.53 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $100.00 Typical High $380.19 | Professional | 56 · Pre-op care only | $15.85 | $100.00 | $380.19 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $234.42 Median $1,905.46 Typical High $3,019.95 | Professional | 63 · Small infant | $234.42 | $1,905.46 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $162.18 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $138.04 | $162.18 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $323.59 Typical High $1,905.46 | Professional | 52 · Reduced service | $79.43 | $323.59 | $1,905.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $131.83 Typical High $758.58 | Professional | 53 · Discontinued | $31.62 | $131.83 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $64.57 Typical High $380.19 | Professional | 56 · Pre-op care only | $15.85 | $64.57 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $239.88 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $275.42 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $173.78 | $275.42 | $1,778.28 |
Where Idaho sits
The same service costs 5.5 times more in Hawaii 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
HI $4,440MD $808
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.