How much rates vary
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $389.05 | Professional | None | $169.82 | $169.82 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $194.98 | Professional | 52 · Reduced service | $85.11 | $85.11 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $77.62 | Professional | 53 · Discontinued | $33.88 | $33.88 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $128.82 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $38.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,698.24 | Facility | None | $537.03 | $1,258.93 | $1,698.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | None | $302.00 | $354.81 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $186.21 Typical High $5,495.41 | Facility | None | $169.82 | $186.21 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $389.05 | Professional | None | $169.82 | $169.82 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $194.98 | Professional | 52 · Reduced service | $85.11 | $85.11 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $77.62 | Professional | 53 · Discontinued | $33.88 | $33.88 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $128.82 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $38.90 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $446.68 Typical High $3,548.13 | Facility | None | $389.05 | $446.68 | $3,548.13 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $251.19 |
Where Idaho sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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.
Idaho· 14th of 51
$339
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.