How much rates vary
Facilitymedian $17 · 10th to 90th $14 to $603Professionalmedian $17 · 10th to 90th $7 to $30
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 $9.33 Median $21.88 Typical High $21.88 | Professional | None | $9.33 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $4.57 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $1.86 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $16.60 Typical High $16.60 | Professional | 54 · Surgery only | $6.92 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $1.38 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.91 | $2.19 | $2.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $11.48 Median $15.85 Typical High $26.30 | Facility | None | $11.48 | $15.85 | $26.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $18.20 | Professional | None | $11.48 | $17.38 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Moda Health Setting Facility Modifier None Typical Low $15.85 Median $16.60 Typical High $31.62 | Facility | None | $15.85 | $16.60 | $31.62 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $21.88 | Professional | None | $11.48 | $17.38 | $21.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $4.57 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $1.86 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $16.60 Typical High $16.60 | Professional | 54 · Surgery only | $6.92 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $1.38 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.91 | $2.19 | $2.19 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $30.20 | Professional | None | $12.02 | $14.13 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $20.42 Median $602.56 Typical High $1,000.00 | Facility | None | $20.42 | $602.56 | $1,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $1,174.90 | Professional | None | $17.38 | $20.42 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $17.38 | Professional | None | $11.48 | $11.48 | $17.38 |
Select Health Setting Facility Modifier None Typical Low $16.22 Median $16.60 Typical High $19.50 | Facility | None | $16.22 | $16.60 | $19.50 |
Select Health Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $38.90 | Professional | None | $16.60 | $18.20 | $38.90 |
United Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $12.30 | Professional | None | $5.37 | $6.92 | $12.30 |
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 $10.72 Median $12.02 Typical High $12.59 | Professional | 78 · Unplanned return to OR | $10.72 | $12.02 | $12.59 |
Where Idaho sits
The same service costs 3.2 times more in Rhode Island 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· 3rd of 51
$17.38
RI $21.38NY $6.61
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.