How much rates vary
Facilitymedian $447 · 10th to 90th $85 to $2,239Professionalmedian $100 · 10th to 90th $62 to $195
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 $117.49 Median $234.42 Typical High $5,495.41 | Facility | None | $117.49 | $234.42 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $194.98 | Professional | None | $58.88 | $100.00 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $74.13 Typical High $147.91 | Professional | 54 · Surgery only | $51.29 | $74.13 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $29.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $213.80 Median $549.54 Typical High $2,089.30 | Facility | None | $213.80 | $549.54 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $194.98 | Professional | None | $66.07 | $114.82 | $194.98 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $69.18 | $123.03 | $173.78 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.32 Typical High $19.50 | Professional | 55 · Aftercare only | $7.76 | $8.32 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $138.04 | Professional | None | $61.66 | $97.72 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $4,466.84 | Facility | None | $100.00 | $194.98 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $194.98 | Professional | None | $63.10 | $117.49 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $74.13 Typical High $147.91 | Professional | 54 · Surgery only | $66.07 | $74.13 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $29.51 |
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 $74.13 Median $74.13 Typical High $177.83 | Facility | None | $74.13 | $74.13 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $186.21 | Professional | None | $74.13 | $131.83 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $91.20 Typical High $138.04 | Professional | 54 · Surgery only | $67.61 | $91.20 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $2,238.72 | Facility | None | $549.54 | $1,548.82 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $165.96 | Professional | None | $66.07 | $112.20 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $616.60 | Facility | None | $85.11 | $87.10 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $112.20 | Professional | None | $67.61 | $85.11 | $112.20 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $8,317.64 Typical High $9,332.54 | Facility | None | $1,862.09 | $8,317.64 | $9,332.54 |
United Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $186.21 | Professional | None | $47.86 | $109.65 | $186.21 |
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 $33.88 Median $50.12 Typical High $97.72 | Professional | 52 · Reduced service | $33.88 | $50.12 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $39.81 | Professional | 53 · Discontinued | $13.80 | $19.95 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $19.50 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $83.18 Median $100.00 Typical High $229.09 | Professional | 63 · Small infant | $83.18 | $100.00 | $229.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $58.88 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $47.86 | $58.88 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $50.12 Typical High $97.72 | Professional | 52 · Reduced service | $43.65 | $50.12 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.95 Typical High $39.81 | Professional | 53 · Discontinued | $17.38 | $19.95 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.00 Typical High $19.50 | Professional | 56 · Pre-op care only | $8.71 | $10.00 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.18 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.77 | $13.18 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $97.72 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $72.44 | $97.72 | $147.91 |
Where Idaho sits
The same service costs 2.5 times more in North Carolina than in Florida. 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
$110
NC $174FL $70.79
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.