How much rates vary
Facilitymedian $525 · 10th to 90th $363 to $891Professionalmedian $457 · 10th to 90th $251 to $692
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 $354.81 Median $457.09 Typical High $457.09 | Professional | None | $354.81 | $457.09 | $457.09 |
BCBS Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Facility | None | $398.11 | $537.03 | $891.25 |
BCBS Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $616.60 | Professional | None | $389.05 | $588.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Facility | None | $363.08 | $363.08 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $457.09 Typical High $562.34 | Facility | None | $162.18 | $457.09 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $588.84 | Professional | None | $354.81 | $501.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $398.11 Typical High $467.74 | Professional | None | $30.20 | $398.11 | $467.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $33,113.11 | Facility | None | $446.68 | $691.83 | $33,113.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $38,904.51 | Professional | None | $562.34 | $691.83 | $38,904.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $794.33 | Facility | None | $524.81 | $537.03 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $707.95 | Facility | None | $562.34 | $562.34 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $616.60 | Professional | None | $363.08 | $562.34 | $616.60 |
United Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $380.19 | Professional | None | $229.09 | $251.19 | $380.19 |
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 $177.83 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $45.71 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $45.71 |
Where Idaho sits
The same service costs 2.2 times more in Montana than in Delaware. 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· 13th of 51
$468
MT $575DE $263
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.