How much rates vary
Facilitymedian $19 · 10th to 90th $15 to $676Professionalmedian $19 · 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 $10.23 Median $24.55 Typical High $24.55 | Professional | None | $10.23 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $5.13 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $2.04 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $18.20 Typical High $18.20 | Professional | 54 · Surgery only | $7.76 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $1.55 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.02 | $2.45 | $2.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $12.88 Median $17.78 Typical High $28.84 | Facility | None | $12.88 | $17.78 | $28.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $12.88 Median $19.50 Typical High $20.42 | Professional | None | $12.88 | $19.50 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $18.20 Typical High $34.67 | Facility | None | $17.38 | $18.20 | $34.67 |
Moda Health Setting Professional Modifier None Typical Low $10.23 Median $19.50 Typical High $24.55 | Professional | None | $10.23 | $19.50 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $5.13 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $2.04 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $18.20 Typical High $18.20 | Professional | 54 · Surgery only | $7.76 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $1.55 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.02 | $2.45 | $2.45 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $30.20 | Professional | None | $13.18 | $15.49 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $22.91 Median $676.08 Typical High $1,096.48 | Facility | None | $22.91 | $676.08 | $1,096.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $1,288.25 | Professional | None | $19.50 | $22.91 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $19.50 | Professional | None | $12.88 | $12.88 | $19.50 |
Select Health Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $21.88 | Facility | None | $18.20 | $18.20 | $21.88 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $42.66 | Professional | None | $18.20 | $19.95 | $42.66 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $13.49 | Professional | None | $6.03 | $7.59 | $13.49 |
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 $12.02 Median $13.49 Typical High $14.13 | Professional | 78 · Unplanned return to OR | $12.02 | $13.49 | $14.13 |
Where Idaho sits
The same service costs 2.7 times more in Idaho 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· 1st of 51
$19.50
ID $19.50NY $7.24
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.