How much rates vary
Facilitymedian $479 · 10th to 90th $145 to $2,951Professionalmedian $295 · 10th to 90th $224 to $437
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 $181.97 Median $436.52 Typical High $436.52 | Professional | None | $181.97 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $64.57 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,630.27 | Facility | None | $537.03 | $1,659.59 | $2,630.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | None | $269.15 | $316.23 | $354.81 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $275.42 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | None | $223.87 | $251.19 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $1,412.54 Typical High $5,495.41 | Facility | None | $218.78 | $1,412.54 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $436.52 Typical High $436.52 | Professional | None | $223.87 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $64.57 | $64.57 |
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 $234.42 Median $288.40 Typical High $288.40 | Facility | None | $234.42 | $288.40 | $288.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | None | $288.40 | $288.40 | $446.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $436.52 | Professional | None | $316.23 | $354.81 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $3,162.28 | Facility | None | $138.04 | $141.25 | $3,162.28 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $275.42 | Professional | None | $138.04 | $181.97 | $275.42 |
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 $194.98 Median $269.15 Typical High $371.54 | Professional | None | $194.98 | $269.15 | $371.54 |
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 $112.20 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $112.20 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $44.67 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.39 | $43.65 | $43.65 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $316.23 Median $371.54 Typical High $407.38 | Professional | 63 · Small infant | $316.23 | $371.54 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $112.20 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $44.67 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.39 | $43.65 | $43.65 |
Where Idaho sits
The same service costs 20.9 times more in Alabama than in Delaware. 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
AL $7,181DE $344
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.