How much rates vary
Facilitymedian $224 · 10th to 90th $148 to $372Professionalmedian $191 · 10th to 90th $105 to $288
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 $147.91 Median $190.55 Typical High $190.55 | Professional | None | $147.91 | $190.55 | $190.55 |
BCBS Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $371.54 | Facility | None | $181.97 | $223.87 | $371.54 |
BCBS Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $257.04 | Professional | None | $162.18 | $245.47 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Facility | None | $165.96 | $165.96 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $190.55 Typical High $229.09 | Facility | None | $67.61 | $190.55 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $245.47 | Professional | None | $147.91 | $218.78 | $245.47 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $165.96 Typical High $194.98 | Professional | None | $30.20 | $165.96 | $194.98 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $13,803.84 | Facility | None | $186.21 | $288.40 | $13,803.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $16,218.10 | Professional | None | $229.09 | $288.40 | $16,218.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $331.13 | Facility | None | $213.80 | $223.87 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $295.12 | Facility | None | $229.09 | $229.09 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $251.19 | Professional | None | $151.36 | $229.09 | $251.19 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
United Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $162.18 | Professional | None | $97.72 | $104.71 | $162.18 |
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 $74.13 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $29.51 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.79 | $19.05 | $19.05 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $74.13 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $29.51 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.79 | $19.05 | $19.05 |
Where Idaho sits
The same service costs 2.8 times more in Hawaii 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· 12th of 51
$195
HI $331DE $120
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.