How much rates vary
Facilitymedian $363 · 10th to 90th $170 to $1,122Professionalmedian $195 · 10th to 90th $141 to $288
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 $141.25 Median $288.40 Typical High $288.40 | Professional | None | $141.25 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $107.15 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $21.38 | $42.66 | $42.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $575.44 Typical High $1,000.00 | Facility | None | $223.87 | $575.44 | $1,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $239.88 | Professional | None | $177.83 | $208.93 | $239.88 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $199.53 | Professional | 54 · Surgery only | $154.88 | $186.21 | $199.53 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $281.84 | Facility | None | $186.21 | $208.93 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | None | $147.91 | $177.83 | $208.93 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $5,495.41 | Facility | None | $147.91 | $288.40 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $288.40 | Professional | None | $147.91 | $263.03 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $109.65 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $21.88 | $42.66 | $42.66 |
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 $158.49 Median $194.98 Typical High $194.98 | Facility | None | $158.49 | $194.98 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $380.19 | Professional | None | $194.98 | $194.98 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $977.24 | Facility | None | $501.19 | $758.58 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $281.84 | Professional | None | $208.93 | $234.42 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $1,348.96 | Facility | None | $91.20 | $93.33 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $147.91 | Professional | None | $91.20 | $91.20 | $147.91 |
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 $128.82 Median $181.97 Typical High $269.15 | Professional | None | $128.82 | $181.97 | $269.15 |
8 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 $70.79 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $70.79 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $28.18 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $14.13 | $28.84 | $28.84 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | 63 · Small infant | $208.93 | $245.47 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $74.13 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $29.51 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $14.79 | $28.84 | $28.84 |
Where Idaho sits
The same service costs 8.9 times more in New York than in Maryland. 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 $2,750MD $308
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.