How much rates vary
Facilitymedian $24 · 10th to 90th $19 to $891Professionalmedian $25 · 10th to 90th $10 to $32
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 $13.49 Median $32.36 Typical High $32.36 | Professional | None | $13.49 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $6.76 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $2.69 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $10.00 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $2.04 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.35 | $3.24 | $3.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $15.14 Median $22.91 Typical High $38.02 | Facility | None | $15.14 | $22.91 | $38.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $26.30 | Professional | None | $16.98 | $25.12 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Moda Health Setting Facility Modifier None Typical Low $22.91 Median $23.99 Typical High $45.71 | Facility | None | $22.91 | $23.99 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $14.45 Median $25.12 Typical High $32.36 | Professional | None | $14.45 | $25.12 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $6.76 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $2.69 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $10.00 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $2.04 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.35 | $3.24 | $3.24 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $30.20 | Professional | None | $17.38 | $20.42 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $30.20 Median $891.25 Typical High $1,445.44 | Facility | None | $30.20 | $891.25 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $1,698.24 | Professional | None | $25.12 | $30.20 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $25.12 | Professional | None | $16.98 | $16.98 | $25.12 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $28.84 | Facility | None | $23.99 | $23.99 | $28.84 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $56.23 | Professional | None | $23.99 | $26.30 | $56.23 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $17.78 | Professional | None | $7.76 | $10.00 | $17.78 |
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 $15.85 Median $17.78 Typical High $18.62 | Professional | 78 · Unplanned return to OR | $15.85 | $17.78 | $18.62 |
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
$25.12
RI $30.20NY $9.55
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.