How much rates vary
Facilitymedian $372 · 10th to 90th $65 to $1,905Professionalmedian $145 · 10th to 90th $100 to $219
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 $123.03 Median $199.53 Typical High $7,079.46 | Facility | None | $123.03 | $199.53 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $190.55 | Professional | None | $83.18 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $72.44 | $102.33 | $144.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $70.79 Median $616.60 Typical High $2,137.96 | Facility | None | $70.79 | $616.60 | $2,137.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $234.42 | Professional | None | $114.82 | $169.82 | $234.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $87.10 | Facility | None | $57.54 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $177.83 | Professional | None | $109.65 | $141.25 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $186.21 Typical High $4,466.84 | Facility | None | $95.50 | $186.21 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $218.78 | Professional | None | $104.71 | $154.88 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $72.44 | $102.33 | $144.54 |
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 $128.82 Median $128.82 Typical High $213.80 | Facility | None | $128.82 | $128.82 | $213.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $269.15 | Professional | None | $128.82 | $181.97 | $269.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,737.80 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $186.21 | Professional | None | $114.82 | $169.82 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $1,318.26 | Facility | None | $102.33 | $102.33 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $141.25 | Professional | None | $81.28 | $102.33 | $141.25 |
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 $85.11 Median $134.90 Typical High $204.17 | Professional | None | $85.11 | $134.90 | $204.17 |
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 $47.86 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $47.86 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $19.05 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $19.05 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $21.88 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $21.88 | $23.99 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $141.25 Median $194.98 Typical High $275.42 | Professional | 63 · Small infant | $141.25 | $194.98 | $275.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $102.33 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $83.18 | $102.33 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $47.86 | $67.61 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $19.05 | $26.92 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $19.05 |
Where Idaho sits
The same service costs 12.3 times more in Connecticut than in West Virginia. 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
CT $2,823WV $230
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.