How much rates vary
Facilitymedian $676 · 10th to 90th $288 to $2,399Professionalmedian $209 · 10th to 90th $123 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 $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 $104.71 Median $213.80 Typical High $346.74 | Professional | None | $104.71 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $162.18 Typical High $257.04 | Professional | 54 · Surgery only | $79.43 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $15.85 | $32.36 | $51.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $676.08 Median $1,071.52 Typical High $2,398.83 | Facility | None | $676.08 | $1,071.52 | $2,398.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $338.84 | Professional | None | $151.36 | $263.03 | $338.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $281.84 Typical High $302.00 | Professional | 54 · Surgery only | $134.90 | $281.84 | $302.00 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $33.88 |
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 $123.03 Median $162.18 Typical High $229.09 | Professional | None | $123.03 | $162.18 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $309.03 Typical High $5,495.41 | Facility | None | $104.71 | $309.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $346.74 | Professional | None | $134.90 | $213.80 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $162.18 Typical High $257.04 | Professional | 54 · Surgery only | $79.43 | $162.18 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $15.85 | $32.36 | $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 $162.18 Median $162.18 Typical High $302.00 | Facility | None | $162.18 | $162.18 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $380.19 | Professional | None | $162.18 | $302.00 | $380.19 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $478.63 | Professional | 54 · Surgery only | $239.88 | $239.88 | $478.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $2,951.21 | Facility | None | $1,584.89 | $2,290.87 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $338.84 | Professional | None | $169.82 | $208.93 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Facility | None | $144.54 | $144.54 | $147.91 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $549.54 | Professional | None | $87.10 | $144.54 | $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 $95.50 Median $158.49 Typical High $281.84 | Professional | None | $95.50 | $158.49 | $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 $52.48 Median $107.15 Typical High $173.78 | Professional | 52 · Reduced service | $52.48 | $107.15 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $42.66 Typical High $69.18 | Professional | 53 · Discontinued | $20.89 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $21.38 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.47 | $21.38 | $34.67 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $181.97 Median $213.80 Typical High $389.05 | Professional | 63 · Small infant | $181.97 | $213.80 | $389.05 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $128.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $104.71 | $128.82 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $107.15 Typical High $173.78 | Professional | 52 · Reduced service | $52.48 | $107.15 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $42.66 Typical High $69.18 | Professional | 53 · Discontinued | $20.89 | $42.66 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $21.38 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.47 | $21.38 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $69.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $512.86 |
Where Idaho sits
The same service costs 7.8 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 $2,820ND $362
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.