How much rates vary
Facilitymedian $20 · 10th to 90th $17 to $741Professionalmedian $21 · 10th to 90th $8 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 $11.22 Median $26.92 Typical High $26.92 | Professional | None | $11.22 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $5.62 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $2.24 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $19.95 Typical High $19.95 | Professional | 54 · Surgery only | $8.51 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $1.70 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.12 | $2.69 | $2.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $14.13 Median $19.05 Typical High $31.62 | Facility | None | $14.13 | $19.05 | $31.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $21.88 | Professional | None | $14.13 | $20.89 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $19.95 Typical High $35.48 | Facility | None | $19.05 | $19.95 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $20.89 Typical High $26.92 | Professional | None | $11.22 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $5.62 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $2.24 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $19.95 Typical High $19.95 | Professional | 54 · Surgery only | $8.51 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $1.70 | $3.98 | $3.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.12 | $2.69 | $2.69 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $16.98 Typical High $30.20 | Professional | None | $14.45 | $16.98 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $25.12 Median $741.31 Typical High $1,202.26 | Facility | None | $25.12 | $741.31 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $1,412.54 | Professional | None | $20.89 | $25.12 | $1,412.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $20.89 | Professional | None | $14.13 | $14.13 | $20.89 |
Select Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Facility | None | $19.95 | $19.95 | $23.99 |
Select Health Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $46.77 | Professional | None | $19.95 | $21.88 | $46.77 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $14.79 | Professional | None | $6.61 | $8.32 | $14.79 |
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 $13.18 Median $14.79 Typical High $15.49 | Professional | 78 · Unplanned return to OR | $13.18 | $14.79 | $15.49 |
Where Idaho sits
The same service costs 2.8 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· 3rd of 51
$20.89
HI $21.88NY $7.94
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.