How much rates vary
Facilitymedian $6 · 10th to 90th $5 to $204Professionalmedian $6 · 10th to 90th $2 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 $3.09 Median $7.24 Typical High $7.24 | Professional | None | $3.09 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $1.55 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $0.62 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $5.50 Typical High $5.50 | Professional | 54 · Surgery only | $2.29 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $0.46 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.31 | $0.72 | $0.72 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.89 Median $5.25 Typical High $8.71 | Facility | None | $3.89 | $5.25 | $8.71 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $6.03 | Professional | None | $3.89 | $5.75 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Moda Health Setting Facility Modifier None Typical Low $5.25 Median $5.50 Typical High $10.47 | Facility | None | $5.25 | $5.50 | $10.47 |
Moda Health Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $7.24 | Professional | None | $3.80 | $5.75 | $7.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $1.55 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $0.62 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2.29 Median $5.50 Typical High $5.50 | Professional | 54 · Surgery only | $2.29 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $0.46 | $1.10 | $1.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.31 | $0.72 | $0.72 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $4.68 Typical High $30.20 | Professional | None | $3.98 | $4.68 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6.92 Median $204.17 Typical High $331.13 | Facility | None | $6.92 | $204.17 | $331.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $389.05 | Professional | None | $5.75 | $6.92 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.75 | Professional | None | $3.89 | $3.89 | $5.75 |
Select Health Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $6.46 | Facility | None | $5.50 | $5.50 | $6.46 |
Select Health Setting Professional Modifier None Typical Low $5.50 Median $6.03 Typical High $12.88 | Professional | None | $5.50 | $6.03 | $12.88 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.29 Typical High $4.07 | Professional | None | $1.78 | $2.29 | $4.07 |
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 $3.63 Median $4.07 Typical High $4.27 | Professional | 78 · Unplanned return to OR | $3.63 | $4.07 | $4.27 |
Where Idaho sits
The same service costs 3.8 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
$5.75
RI $8.32NY $2.19
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.