How much rates vary
Facilitymedian $46 · 10th to 90th $37 to $1,660Professionalmedian $45 · 10th to 90th $18 to $60
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 $25.12 Median $60.26 Typical High $60.26 | Professional | None | $25.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $12.59 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $5.01 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $44.67 Typical High $44.67 | Professional | 54 · Surgery only | $18.62 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $3.80 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.51 | $6.03 | $6.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $70.79 | Facility | None | $31.62 | $42.66 | $70.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $48.98 | Professional | None | $31.62 | $46.77 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $44.67 Typical High $85.11 | Facility | None | $42.66 | $44.67 | $85.11 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $60.26 | Professional | None | $30.90 | $46.77 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $12.59 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $5.01 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $44.67 Typical High $44.67 | Professional | 54 · Surgery only | $18.62 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $3.80 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.51 | $6.03 | $6.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $38.02 | Professional | None | $30.20 | $32.36 | $38.02 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $56.23 Median $1,659.59 Typical High $2,691.53 | Facility | None | $56.23 | $1,659.59 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $3,162.28 | Professional | None | $46.77 | $56.23 | $3,162.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $46.77 | Professional | None | $31.62 | $31.62 | $46.77 |
Select Health Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Facility | None | $44.67 | $44.67 | $52.48 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $104.71 | Professional | None | $44.67 | $48.98 | $104.71 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $33.11 | Professional | None | $14.45 | $18.62 | $33.11 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $33.11 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $29.51 | $33.11 | $34.67 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 4th of 51
$44.67
HI $47.86NY $17.78
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.