How much rates vary
Facilitymedian $191 · 10th to 90th $83 to $741Professionalmedian $117 · 10th to 90th $68 to $214
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 $85.11 Median $1,412.54 Typical High $7,079.46 | Facility | None | $85.11 | $1,412.54 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $218.78 | Professional | None | $66.07 | $117.49 | $218.78 |
BCBS Setting Facility Modifier None Typical Low $87.10 Median $288.40 Typical High $741.31 | Facility | None | $87.10 | $288.40 | $741.31 |
BCBS Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $218.78 | Professional | None | $79.43 | $151.36 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $83.18 Typical High $114.82 | Facility | None | $74.13 | $83.18 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $151.36 | Professional | None | $72.44 | $107.15 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $144.54 Typical High $4,466.84 | Facility | None | $74.13 | $144.54 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $218.78 | Professional | None | $66.07 | $117.49 | $218.78 |
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 $91.20 Median $91.20 Typical High $194.98 | Facility | None | $91.20 | $91.20 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $208.93 | Professional | None | $91.20 | $154.88 | $208.93 |
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 $79.43 Median $102.33 Typical High $158.49 | Professional | None | $79.43 | $102.33 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $426.58 | Facility | None | $93.33 | $95.50 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $123.03 | Professional | None | $57.54 | $93.33 | $123.03 |
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 $57.54 Median $102.33 Typical High $173.78 | Professional | None | $57.54 | $102.33 | $173.78 |
14 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 $33.11 Median $57.54 Typical High $109.65 | Professional | 52 · Reduced service | $33.11 | $57.54 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.44 Typical High $43.65 | Professional | 53 · Discontinued | $13.18 | $23.44 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $87.10 Typical High $162.18 | Professional | 54 · Surgery only | $48.98 | $87.10 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.38 Typical High $33.11 | Professional | 55 · Aftercare only | $10.00 | $17.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $21.88 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $190.55 | Professional | 54 · Surgery only | $75.86 | $89.13 | $190.55 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $21.38 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $21.38 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $123.03 Typical High $263.03 | Professional | 63 · Small infant | $102.33 | $123.03 | $263.03 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $61.66 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $61.66 Typical High $109.65 | Professional | 52 · Reduced service | $33.11 | $61.66 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.44 Typical High $43.65 | Professional | 53 · Discontinued | $13.18 | $23.44 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $87.10 Typical High $162.18 | Professional | 54 · Surgery only | $48.98 | $87.10 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.38 Typical High $33.11 | Professional | 55 · Aftercare only | $10.00 | $17.38 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $21.88 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin 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.
Idaho· 17th of 51
$120
WI $257KY $91.20
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.