How much rates vary
Facilitymedian $17 · 10th to 90th $14 to $631Professionalmedian $18 · 10th to 90th $7 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 $9.55 Median $22.91 Typical High $22.91 | Professional | None | $9.55 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $4.79 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $1.91 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $16.98 Typical High $16.98 | Professional | 54 · Surgery only | $7.24 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $1.45 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.95 | $2.29 | $2.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $12.02 Median $16.22 Typical High $28.18 | Facility | None | $12.02 | $16.22 | $28.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $19.05 | Professional | None | $12.02 | $18.20 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $16.98 Typical High $29.51 | Facility | None | $16.22 | $16.98 | $29.51 |
Moda Health Setting Professional Modifier None Typical Low $9.55 Median $18.20 Typical High $22.91 | Professional | None | $9.55 | $18.20 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $4.79 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $1.91 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $16.98 Typical High $16.98 | Professional | 54 · Surgery only | $7.24 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $1.45 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.95 | $2.29 | $2.29 |
Molina Setting Professional Modifier None Typical Low $12.30 Median $14.45 Typical High $30.20 | Professional | None | $12.30 | $14.45 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $21.38 Median $630.96 Typical High $1,023.29 | Facility | None | $21.38 | $630.96 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $1,202.26 | Professional | None | $18.20 | $21.38 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $18.20 | Professional | None | $12.02 | $12.02 | $18.20 |
Select Health Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $20.42 | Facility | None | $16.98 | $16.98 | $20.42 |
Select Health Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $39.81 | Professional | None | $16.98 | $18.62 | $39.81 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.08 Typical High $12.59 | Professional | None | $5.62 | $7.08 | $12.59 |
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 $11.22 Median $12.59 Typical High $13.18 | Professional | 78 · Unplanned return to OR | $11.22 | $12.59 | $13.18 |
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· 2nd of 51
$18.20
HI $18.62NY $6.76
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.