How much rates vary
Facilitymedian $26 · 10th to 90th $21 to $933Professionalmedian $27 · 10th to 90th $10 to $34
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 $14.13 Median $33.88 Typical High $33.88 | Professional | None | $14.13 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $7.08 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $2.82 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $25.70 Typical High $25.70 | Professional | 54 · Surgery only | $10.72 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $2.14 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.45 | $3.39 | $3.39 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.78 Median $23.99 Typical High $40.74 | Facility | None | $17.78 | $23.99 | $40.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $28.18 | Professional | None | $17.78 | $26.92 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $25.70 Typical High $45.71 | Facility | None | $23.99 | $25.70 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $14.13 Median $26.92 Typical High $33.88 | Professional | None | $14.13 | $26.92 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $7.08 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $2.82 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $25.70 Typical High $25.70 | Professional | 54 · Surgery only | $10.72 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $2.14 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.45 | $3.39 | $3.39 |
Molina Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $30.20 | Professional | None | $18.20 | $21.38 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $31.62 Median $933.25 Typical High $1,513.56 | Facility | None | $31.62 | $933.25 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $1,778.28 | Professional | None | $26.92 | $31.62 | $1,778.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $26.92 | Professional | None | $17.78 | $17.78 | $26.92 |
Select Health Setting Facility Modifier None Typical Low $25.12 Median $25.70 Typical High $30.20 | Facility | None | $25.12 | $25.70 | $30.20 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $58.88 | Professional | None | $25.70 | $28.18 | $58.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $19.05 | Professional | None | $8.32 | $10.47 | $19.05 |
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 $16.60 Median $18.62 Typical High $19.50 | Professional | 78 · Unplanned return to OR | $16.60 | $18.62 | $19.50 |
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
$26.92
HI $27.54NY $10.00
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.