How much rates vary
Facilitymedian $2,344 · 10th to 90th $912 to $8,511Professionalmedian $724 · 10th to 90th $501 to $912
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 $1,096.48 Median $4,466.84 Typical High $8,709.64 | Facility | None | $1,096.48 | $4,466.84 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $912.01 | Professional | None | $467.74 | $645.65 | $912.01 |
BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,630.27 | $9,120.11 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $2,454.71 Median $3,630.78 Typical High $13,489.63 | Facility | 50 · Both sides | $2,454.71 | $3,630.78 | $13,489.63 |
BCBS Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,023.29 | Professional | None | $691.83 | $851.14 | $1,023.29 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,548.82 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $776.25 | Professional | None | $575.44 | $660.69 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $3,388.44 Typical High $6,606.93 | Facility | None | $489.78 | $3,388.44 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $912.01 | Professional | None | $512.86 | $831.76 | $912.01 |
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 $660.69 Median $812.83 Typical High $812.83 | Facility | None | $660.69 | $812.83 | $812.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,380.38 | Professional | None | $812.83 | $812.83 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,511.38 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | None | $691.83 | $691.83 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $398.11 Typical High $6,165.95 | Facility | None | $389.05 | $398.11 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $933.25 | Professional | None | $457.09 | $660.69 | $933.25 |
16 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 $269.15 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $269.15 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $107.15 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $81.28 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $53.70 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $630.96 | $630.96 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $776.25 | $831.76 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $91.20 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 63 · Small infant | $891.25 | $1,047.13 | $1,096.48 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $302.00 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $120.23 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $446.68 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $60.26 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $416.87 | $630.96 | $630.96 |
Where Idaho sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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· 15th of 51
$871
OK $3,020UT $339
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.