How much rates vary
Facilitymedian $37 · 10th to 90th $30 to $1,349Professionalmedian $37 · 10th to 90th $15 to $49
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 $20.42 Median $48.98 Typical High $48.98 | Professional | None | $20.42 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $10.23 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $4.07 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $15.49 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $3.09 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.04 | $4.90 | $4.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $23.44 Median $34.67 Typical High $58.88 | Facility | None | $23.44 | $34.67 | $58.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $40.74 | Professional | None | $25.70 | $38.90 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $69.18 | Facility | None | $34.67 | $37.15 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $38.90 Typical High $48.98 | Professional | None | $20.42 | $38.90 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $10.23 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $4.07 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $15.49 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $3.09 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.04 | $4.90 | $4.90 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $30.90 | Professional | None | $26.30 | $30.20 | $30.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $45.71 Median $1,348.96 Typical High $2,187.76 | Facility | None | $45.71 | $1,348.96 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $2,570.40 | Professional | None | $38.90 | $45.71 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | None | $25.70 | $25.70 | $38.90 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $43.65 | Facility | None | $36.31 | $37.15 | $43.65 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $85.11 | Professional | None | $37.15 | $40.74 | $85.11 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $27.54 | Professional | None | $12.02 | $15.14 | $27.54 |
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 $23.99 Median $26.92 Typical High $28.18 | Professional | 78 · Unplanned return to OR | $23.99 | $26.92 | $28.18 |
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
$37.15
HI $39.81NY $14.45
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.