How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,455 to $6,026Professionalmedian $3,090 · 10th to 90th $1,698 to $4,786
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 $2,398.83 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,398.83 | $3,090.30 | $3,090.30 |
BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $6,025.60 | Facility | None | $2,884.03 | $3,630.78 | $6,025.60 |
BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,981.07 | $4,168.69 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,754.23 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,754.23 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,570.40 | Facility | None | $2,454.71 | $2,454.71 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $3,090.30 Typical High $3,801.89 | Facility | None | $1,096.48 | $3,090.30 | $3,801.89 |
Moda Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,398.83 | $3,388.44 | $3,981.07 |
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 $3,019.95 Median $4,786.30 Typical High $229,086.77 | Facility | None | $3,019.95 | $4,786.30 | $229,086.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $269,153.48 | Professional | None | $3,801.89 | $4,786.30 | $269,153.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $5,495.41 | Facility | None | $3,548.13 | $3,630.78 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,630.27 | $2,630.27 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,897.79 | Facility | None | $3,801.89 | $3,801.89 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $4,168.69 | Professional | None | $2,454.71 | $3,801.89 | $4,168.69 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,698.24 | $2,630.27 |
4 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 55 · Aftercare only Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $363.08 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $239.88 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $363.08 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $239.88 | $309.03 | $309.03 |
Where Idaho sits
The same service costs 2.3 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· 11th of 51
$3,236
MT $4,074DE $1,778
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.