How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,659.59 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,737.80 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,412.54 | $1,445.44 | $2,041.74 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $144.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,513.56 Typical High $1,513.56 | Professional | None | $30.20 | $1,513.56 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,737.80 | $1,737.80 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,737.80 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,047.13 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,230.27 |
Where Idaho sits
The same service costs 36.3 times more in Hawaii than in New York. 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· 19th of 51
$1,445
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.