How much rates vary
Facilitymedian $79 · 10th to 90th $55 to $98Professionalmedian $81 · 10th to 90th $62 to $120
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 Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | None | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.92 | $6.92 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $120.23 | Professional | None | $81.28 | $112.20 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $97.72 | Facility | None | $61.66 | $69.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | None | $61.66 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.92 | $6.92 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $77.62 | Professional | None | $30.20 | $30.20 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $134.90 | Facility | None | $48.98 | $79.43 | $134.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $165.96 | Professional | None | $54.95 | $93.33 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Facility | None | $72.44 | $79.43 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $100.00 | Professional | None | $42.66 | $50.12 | $100.00 |
United Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $93.33 | Professional | None | $53.70 | $70.79 | $93.33 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $77.62 | $77.62 | $77.62 |
Where Idaho sits
The same service costs 3.0 times more in North Dakota 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· 5th of 51
$81.28
ND $129NY $42.66
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.