How much rates vary
Facilitymedian $537 · 10th to 90th $282 to $2,089Professionalmedian $263 · 10th to 90th $158 to $417
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 $281.84 Median $489.78 Typical High $5,495.41 | Facility | None | $281.84 | $489.78 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $416.87 | Professional | None | $138.04 | $281.84 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $208.93 Typical High $309.03 | Professional | 54 · Surgery only | $104.71 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $20.89 | $41.69 | $61.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $1,819.70 | Facility | None | $524.81 | $707.95 | $1,819.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $380.19 | Professional | None | $190.55 | $302.00 | $380.19 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $173.78 | $288.40 | $338.84 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $645.65 | Facility | None | $426.58 | $478.63 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | None | $158.49 | $190.55 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $645.65 Typical High $4,265.80 | Facility | None | $177.83 | $645.65 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $416.87 | Professional | None | $169.82 | $281.84 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $208.93 Typical High $309.03 | Professional | 54 · Surgery only | $104.71 | $208.93 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $20.89 | $41.69 | $61.66 |
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 $204.17 Median $204.17 Typical High $338.84 | Facility | None | $204.17 | $204.17 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $426.58 | Professional | None | $204.17 | $338.84 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $524.81 | Professional | 54 · Surgery only | $288.40 | $288.40 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,230.27 | $1,778.28 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $407.38 | Professional | None | $223.87 | $275.42 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $1,513.56 | Facility | None | $162.18 | $162.18 | $1,513.56 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $436.52 | Professional | None | $114.82 | $162.18 | $436.52 |
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 $123.03 Median $190.55 Typical High $331.13 | Professional | None | $123.03 | $190.55 | $331.13 |
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 $69.18 Median $141.25 Typical High $208.93 | Professional | 52 · Reduced service | $69.18 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $56.23 Typical High $83.18 | Professional | 53 · Discontinued | $28.18 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $28.18 Typical High $41.69 | Professional | 56 · Pre-op care only | $13.80 | $28.18 | $41.69 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $223.87 Median $389.05 Typical High $457.09 | Professional | 63 · Small infant | $223.87 | $389.05 | $457.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $134.90 | $218.78 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $141.25 Typical High $208.93 | Professional | 52 · Reduced service | $69.18 | $141.25 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $56.23 Typical High $83.18 | Professional | 53 · Discontinued | $28.18 | $56.23 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $28.18 Typical High $41.69 | Professional | 56 · Pre-op care only | $13.80 | $28.18 | $41.69 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $74.13 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $562.34 |
Where Idaho sits
The same service costs 6.3 times more in New York than in Montana. 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 $2,712MT $427
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.