How much rates vary
Facilitymedian $6 · 10th to 90th $5 to $214Professionalmedian $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 $3.24 Median $7.76 Typical High $7.76 | Professional | None | $3.24 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $1.62 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $0.65 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $5.75 Typical High $5.75 | Professional | 54 · Surgery only | $2.45 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $0.49 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.33 | $0.78 | $0.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.07 Median $5.50 Typical High $9.33 | Facility | None | $4.07 | $5.50 | $9.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.07 Median $6.03 Typical High $6.31 | Professional | None | $4.07 | $6.03 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Moda Health Setting Facility Modifier None Typical Low $5.50 Median $5.75 Typical High $10.96 | Facility | None | $5.50 | $5.75 | $10.96 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $6.03 Typical High $7.76 | Professional | None | $3.24 | $6.03 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $1.62 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $0.65 | $1.55 | $1.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $5.75 Typical High $5.75 | Professional | 54 · Surgery only | $2.45 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $0.49 | $1.15 | $1.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.33 | $0.78 | $0.78 |
Molina Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $30.20 | Professional | None | $4.17 | $4.90 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $7.24 Median $213.80 Typical High $346.74 | Facility | None | $7.24 | $213.80 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.03 Median $7.24 Typical High $407.38 | Professional | None | $6.03 | $7.24 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $6.03 | Professional | None | $4.07 | $4.07 | $6.03 |
Select Health Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $6.92 | Facility | None | $5.75 | $5.75 | $6.92 |
Select Health Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $13.49 | Professional | None | $5.75 | $6.31 | $13.49 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.40 Typical High $4.27 | Professional | None | $1.91 | $2.40 | $4.27 |
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 $3.80 Median $4.27 Typical High $4.47 | Professional | 78 · Unplanned return to OR | $3.80 | $4.27 | $4.47 |
Where Idaho sits
The same service costs 3.0 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· 4th of 51
$6.03
RI $6.76NY $2.29
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.