How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,148 to $11,749Professionalmedian $1,122 · 10th to 90th $646 to $1,479
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 $1,737.80 Median $4,466.84 Typical High $5,495.41 | Facility | None | $1,737.80 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $1,479.11 Typical High $1,659.59 | Professional | None | $630.96 | $1,479.11 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $758.58 | $1,096.48 | $1,096.48 |
BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $5,248.07 Typical High $13,489.63 | Facility | None | $2,238.72 | $5,248.07 | $13,489.63 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $7,943.28 Typical High $22,387.21 | Facility | 50 · Both sides | $2,951.21 | $7,943.28 | $22,387.21 |
BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,288.25 | $1,698.24 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,584.89 | $1,862.09 | $2,570.40 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,513.56 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $4,897.79 Typical High $6,760.83 | Facility | None | $4,365.16 | $4,897.79 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,071.52 | Professional | None | $549.54 | $954.99 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $5,495.41 | Facility | None | $1,023.29 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,479.11 | Professional | None | $630.96 | $1,122.02 | $1,479.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $1,096.48 | $1,096.48 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Facility | None | $933.25 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,148.15 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,317.64 Median $11,748.98 Typical High $16,982.44 | Facility | None | $8,317.64 | $11,748.98 | $16,982.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $562.34 | Facility | None | $549.54 | $549.54 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $5,248.07 | Professional | None | $549.54 | $870.96 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,548.13 | Facility | None | $1,698.24 | $2,238.72 | $3,548.13 |
United Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,318.26 | Professional | None | $707.95 | $977.24 | $1,318.26 |
11 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 $512.86 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $151.36 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $147.91 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $169.82 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 63 · Small infant | $1,230.27 | $1,479.11 | $2,041.74 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $524.81 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $208.93 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $158.49 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $104.71 | $147.91 | $147.91 |
Where Idaho sits
The same service costs 5.9 times more in Alaska 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
AK $12,304MT $2,095
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.