How much rates vary
Facilitymedian $43 · 10th to 90th $34 to $1,585Professionalmedian $43 · 10th to 90th $17 to $56
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 $23.99 Median $56.23 Typical High $56.23 | Professional | None | $23.99 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $12.02 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $4.79 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $42.66 Typical High $42.66 | Professional | 54 · Surgery only | $17.78 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $3.63 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.40 | $5.75 | $5.75 |
BCBS Idaho Setting Facility Modifier None Typical Low $26.92 Median $39.81 Typical High $67.61 | Facility | None | $26.92 | $39.81 | $67.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $46.77 | Professional | None | $30.20 | $44.67 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $61.66 | Facility | None | $40.74 | $42.66 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $44.67 Typical High $56.23 | Professional | None | $23.99 | $44.67 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $12.02 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $4.79 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $42.66 Typical High $42.66 | Professional | 54 · Surgery only | $17.78 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $3.63 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.40 | $5.75 | $5.75 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $36.31 | Professional | None | $30.20 | $30.90 | $36.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $53.70 Median $1,584.89 Typical High $2,570.40 | Facility | None | $53.70 | $1,584.89 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $3,019.95 | Professional | None | $44.67 | $53.70 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Facility | None | $42.66 | $42.66 | $50.12 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $100.00 | Professional | None | $42.66 | $46.77 | $100.00 |
United Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $31.62 | Professional | None | $13.80 | $17.78 | $31.62 |
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 $28.18 Median $31.62 Typical High $33.11 | Professional | 78 · Unplanned return to OR | $28.18 | $31.62 | $33.11 |
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
$42.66
HI $45.71NY $16.60
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.