How much rates vary
Facilitymedian $30 · 10th to 90th $21 to $52Professionalmedian $27 · 10th to 90th $19 to $40
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 $19.95 Median $25.70 Typical High $25.70 | Professional | None | $19.95 | $25.70 | $25.70 |
BCBS Setting Facility Modifier None Typical Low $25.70 Median $30.20 Typical High $52.48 | Facility | None | $25.70 | $30.20 | $52.48 |
BCBS Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $34.67 | Professional | None | $21.88 | $33.11 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Facility | None | $25.12 | $25.12 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Moda Health Setting Facility Modifier None Typical Low $9.12 Median $25.70 Typical High $31.62 | Facility | None | $9.12 | $25.70 | $31.62 |
Moda Health Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $33.11 | Professional | None | $19.95 | $28.18 | $33.11 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $30.20 | Professional | None | $22.91 | $26.92 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $25.12 Median $39.81 Typical High $1,905.46 | Facility | None | $25.12 | $39.81 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $2,238.72 | Professional | None | $31.62 | $39.81 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $29.51 Median $30.20 Typical High $45.71 | Facility | None | $29.51 | $30.20 | $45.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | None | $21.88 | $21.88 | $33.11 |
Select Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $40.74 | Facility | None | $31.62 | $31.62 | $40.74 |
Select Health Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $34.67 | Professional | None | $20.42 | $31.62 | $34.67 |
United Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $21.88 | Professional | None | $13.18 | $14.13 | $21.88 |
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 $10.00 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $3.98 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.02 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.00 | $2.57 | $2.57 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $22.91 Typical High $23.99 | Professional | 78 · Unplanned return to OR | $20.42 | $22.91 | $23.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $10.00 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $3.98 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.02 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.00 | $2.57 | $2.57 |
Where Idaho sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 9th of 51
$28.18
MN $37.15DC $17.38
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.