How much rates vary
Facilitymedian $158 · 10th to 90th $120 to $200Professionalmedian $178 · 10th to 90th $135 to $234
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 $134.90 Median $151.36 Typical High $151.36 | Professional | None | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $26.92 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $20.42 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.49 | $15.14 | $15.14 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $234.42 | Professional | None | $177.83 | $218.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $151.36 Typical High $213.80 | Facility | None | $134.90 | $151.36 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | None | $134.90 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $67.61 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $26.92 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $20.42 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.49 | $15.14 | $15.14 |
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 $107.15 Median $173.78 Typical High $269.15 | Facility | None | $107.15 | $173.78 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $331.13 | Professional | None | $120.23 | $199.53 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $251.19 | Professional | None | $144.54 | $186.21 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $162.18 | Facility | None | $147.91 | $158.49 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $213.80 | Professional | None | $93.33 | $109.65 | $213.80 |
United Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $199.53 | Professional | None | $117.49 | $154.88 | $199.53 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $154.88 |
Where Idaho sits
The same service costs 2.8 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
$178
ND $257NY $93.33
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.