How much rates vary
Facilitymedian $76 · 10th to 90th $60 to $2,754Professionalmedian $76 · 10th to 90th $31 to $100
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 $41.69 Median $100.00 Typical High $100.00 | Professional | None | $41.69 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $20.89 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $8.32 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $31.62 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $6.31 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.17 | $10.00 | $10.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $120.23 | Facility | None | $47.86 | $70.79 | $120.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $83.18 | Professional | None | $52.48 | $79.43 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $144.54 | Facility | None | $70.79 | $75.86 | $144.54 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $100.00 | Professional | None | $41.69 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $20.89 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $8.32 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $31.62 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $6.31 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.17 | $10.00 | $10.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $53.70 Typical High $63.10 | Professional | None | $30.20 | $53.70 | $63.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $93.33 Median $2,754.23 Typical High $4,466.84 | Facility | None | $93.33 | $2,754.23 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $5,248.07 | Professional | None | $79.43 | $93.33 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | None | $52.48 | $52.48 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $89.13 | Facility | None | $74.13 | $75.86 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $173.78 | Professional | None | $75.86 | $83.18 | $173.78 |
United Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $54.95 | Professional | None | $24.55 | $31.62 | $54.95 |
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 $48.98 Median $54.95 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $48.98 | $54.95 | $57.54 |
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· 5th of 51
$75.86
HI $81.28NY $29.51
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.