How much rates vary
Facilitymedian $182 · 10th to 90th $138 to $447Professionalmedian $178 · 10th to 90th $102 to $309
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 $112.20 Median $177.83 Typical High $177.83 | Professional | None | $112.20 | $177.83 | $177.83 |
BCBS Setting Facility Modifier None Typical Low $138.04 Median $281.84 Typical High $389.05 | Facility | None | $138.04 | $281.84 | $389.05 |
BCBS Setting Professional Modifier None Typical Low $102.33 Median $295.12 Typical High $309.03 | Professional | None | $102.33 | $295.12 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Facility | None | $213.80 | $213.80 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $147.91 Typical High $194.98 | Facility | None | $69.18 | $147.91 | $194.98 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $177.83 | Professional | None | $100.00 | $154.88 | $177.83 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $204.17 Typical High $239.88 | Professional | None | $30.20 | $204.17 | $239.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $8,709.64 | Facility | None | $173.78 | $181.97 | $8,709.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $10,232.93 | Professional | None | $147.91 | $181.97 | $10,232.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $269.15 | Facility | None | $138.04 | $138.04 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | None | $102.33 | $102.33 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $281.84 | Professional | None | $147.91 | $239.88 | $281.84 |
United Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $194.98 | Professional | None | $144.54 | $154.88 | $194.98 |
9 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 $56.23 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $56.23 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $22.91 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $17.78 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $56.23 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $22.91 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $17.78 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 29th of 51
$178
HI $347UT $132
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.