How much rates vary
Facilitymedian $676 · 10th to 90th $229 to $2,399Professionalmedian $200 · 10th to 90th $115 to $339
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 $199.53 Median $407.38 Typical High $7,079.46 | Facility | None | $199.53 | $407.38 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $338.84 | Professional | None | $100.00 | $199.53 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $257.04 | Professional | 54 · Surgery only | $75.86 | $147.91 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $30.20 Typical High $51.29 | Professional | 55 · Aftercare only | $15.14 | $30.20 | $51.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $2,398.83 | Facility | None | $645.65 | $870.96 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $323.59 | Professional | None | $134.90 | $257.04 | $323.59 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $288.40 | Professional | 54 · Surgery only | $123.03 | $147.91 | $288.40 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $13.49 | $26.30 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $812.83 | Facility | None | $537.03 | $602.56 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $229.09 | Professional | None | $114.82 | $154.88 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $338.84 Typical High $4,466.84 | Facility | None | $134.90 | $338.84 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $338.84 | Professional | None | $123.03 | $199.53 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $257.04 | Professional | 54 · Surgery only | $75.86 | $147.91 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $30.20 Typical High $51.29 | Professional | 55 · Aftercare only | $15.14 | $30.20 | $51.29 |
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 $147.91 Median $147.91 Typical High $281.84 | Facility | None | $147.91 | $147.91 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $354.81 | Professional | None | $147.91 | $281.84 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $676.08 | Professional | 54 · Surgery only | $234.42 | $234.42 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,230.27 | $2,041.74 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $331.13 | Professional | None | $158.49 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $549.54 | Professional | None | $79.43 | $134.90 | $549.54 |
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 $93.33 Median $162.18 Typical High $281.84 | Professional | None | $93.33 | $162.18 | $281.84 |
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 $50.12 Median $100.00 Typical High $169.82 | Professional | 52 · Reduced service | $50.12 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $69.18 | Professional | 53 · Discontinued | $19.95 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $33.88 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $162.18 Median $316.23 Typical High $380.19 | Professional | 63 · Small infant | $162.18 | $316.23 | $380.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $112.20 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $95.50 | $112.20 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $100.00 Typical High $169.82 | Professional | 52 · Reduced service | $50.12 | $100.00 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $69.18 | Professional | 53 · Discontinued | $19.95 | $39.81 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $97.72 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $97.72 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $724.44 |
Where Idaho sits
The same service costs 8.0 times more in New York than in North Dakota. 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 $2,762ND $346
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.