How much rates vary
Facilitymedian $204 · 10th to 90th $40 to $525Professionalmedian $41 · 10th to 90th $26 to $69
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 $41.69 Median $41.69 Typical High $69.18 | Facility | None | $41.69 | $41.69 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $57.54 | Professional | None | $31.62 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.47 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.55 | $4.47 | $5.75 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $602.56 | Facility | None | $125.89 | $257.04 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $91.20 | Professional | None | $25.70 | $45.71 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $39.81 Typical High $40.74 | Professional | None | $24.55 | $39.81 | $40.74 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $204.17 Typical High $446.68 | Facility | None | $39.81 | $204.17 | $446.68 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $69.18 | Professional | None | $34.67 | $41.69 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.17 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.55 | $4.17 | $5.75 |
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 $24.55 Median $35.48 Typical High $47.86 | Facility | None | $24.55 | $35.48 | $47.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $47.86 Typical High $63.10 | Professional | None | $24.55 | $47.86 | $63.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $4.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $43.65 Typical High $63.10 | Professional | None | $25.70 | $43.65 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $40.74 Typical High $239.88 | Facility | None | $39.81 | $40.74 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | None | $39.81 | $39.81 | $56.23 |
United Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $44.67 | Professional | None | $26.30 | $38.90 | $44.67 |
5 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 55 · Aftercare only Typical Low $5.25 Median $6.61 Typical High $8.71 | Professional | 55 · Aftercare only | $5.25 | $6.61 | $8.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $27.54 Median $34.67 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $27.54 | $34.67 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.31 Typical High $8.71 | Professional | 55 · Aftercare only | $5.25 | $6.31 | $8.71 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $34.67 | Professional | 54 · Surgery only | $19.95 | $19.95 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.38 Median $21.38 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $21.38 | $21.38 | $37.15 |
Where Idaho sits
The same service costs 86.3 times more in Connecticut than in New Jersey. 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
CT $4,814NJ $55.76
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.