How much rates vary
Facilitymedian $115 · 10th to 90th $87 to $174Professionalmedian $95 · 10th to 90th $81 to $107
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 $87.10 Median $107.15 Typical High $107.15 | Professional | None | $87.10 | $107.15 | $107.15 |
BCBS Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $181.97 | Facility | None | $114.82 | $138.04 | $181.97 |
BCBS Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | None | $83.18 | $93.33 | $102.33 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $56.23 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $218.78 | Facility | None | $120.23 | $120.23 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Facility | None | $85.11 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $107.15 | Professional | None | $85.11 | $102.33 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $125.89 | Facility | None | $93.33 | $95.50 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | None | $81.28 | $97.72 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $181.97 | Facility | None | $109.65 | $123.03 | $181.97 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | None | $93.33 | $102.33 | $107.15 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $181.97 | Facility | None | $85.11 | $85.11 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $123.03 | Professional | None | $85.11 | $85.11 | $123.03 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
7 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 52 · Reduced service Typical Low $43.65 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $43.65 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $17.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.33 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $44.67 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $17.78 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $15.49 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 3rd of 51
$95.50
AK $105RI $85.11
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.