How much rates vary
Facilitymedian $269 · 10th to 90th $155 to $741Professionalmedian $269 · 10th to 90th $178 to $490
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 $147.91 Median $263.03 Typical High $436.52 | Professional | None | $147.91 | $263.03 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $128.82 | $199.53 | $323.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $741.31 | Facility | None | $169.82 | $288.40 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $524.81 | Professional | None | $204.17 | $346.74 | $524.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $416.87 | Professional | 54 · Surgery only | $213.80 | $251.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $229.09 | Facility | None | $151.36 | $169.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $346.74 | Professional | None | $186.21 | $245.47 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $436.52 Typical High $5,495.41 | Facility | None | $162.18 | $436.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $436.52 | Professional | None | $208.93 | $281.84 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $128.82 | $199.53 | $323.59 |
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 $251.19 Median $251.19 Typical High $489.78 | Facility | None | $251.19 | $251.19 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $489.78 | Professional | None | $251.19 | $389.05 | $489.78 |
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 $204.17 Median $269.15 Typical High $363.08 | Professional | None | $204.17 | $269.15 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $512.86 | Facility | None | $234.42 | $234.42 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $281.84 | Professional | None | $158.49 | $234.42 | $281.84 |
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 $147.91 Median $234.42 Typical High $389.05 | Professional | None | $147.91 | $234.42 | $389.05 |
11 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 $87.10 Median $131.83 Typical High $218.78 | Professional | 52 · Reduced service | $87.10 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $87.10 | Professional | 53 · Discontinued | $34.67 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $43.65 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $22.91 | $41.69 | $52.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $275.42 Median $501.19 Typical High $660.69 | Professional | 63 · Small infant | $275.42 | $501.19 | $660.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $131.83 Typical High $218.78 | Professional | 52 · Reduced service | $87.10 | $131.83 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $87.10 | Professional | 53 · Discontinued | $34.67 | $52.48 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $43.65 |
Where Idaho sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.