How much rates vary
Facilitymedian $44 · 10th to 90th $35 to $1,585Professionalmedian $44 · 10th to 90th $18 to $58
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 $24.55 Median $57.54 Typical High $57.54 | Professional | None | $24.55 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $12.02 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $4.90 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $43.65 Typical High $43.65 | Professional | 54 · Surgery only | $18.20 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $3.63 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.45 | $5.75 | $5.75 |
BCBS Idaho Setting Facility Modifier None Typical Low $27.54 Median $40.74 Typical High $69.18 | Facility | None | $27.54 | $40.74 | $69.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $47.86 | Professional | None | $30.20 | $45.71 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Moda Health Setting Facility Modifier None Typical Low $41.69 Median $43.65 Typical High $83.18 | Facility | None | $41.69 | $43.65 | $83.18 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $45.71 Typical High $57.54 | Professional | None | $24.55 | $45.71 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $12.02 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $4.90 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $43.65 Typical High $43.65 | Professional | 54 · Surgery only | $18.20 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $3.63 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.45 | $5.75 | $5.75 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $37.15 | Professional | None | $30.20 | $31.62 | $37.15 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $54.95 Median $1,584.89 Typical High $2,630.27 | Facility | None | $54.95 | $1,584.89 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $3,090.30 | Professional | None | $45.71 | $54.95 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $45.71 | Professional | None | $30.20 | $30.20 | $45.71 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $43.65 Typical High $51.29 | Facility | None | $42.66 | $43.65 | $51.29 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $102.33 | Professional | None | $43.65 | $47.86 | $102.33 |
United Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $32.36 | Professional | None | $14.13 | $18.20 | $32.36 |
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
$43.65
HI $46.77NY $16.98
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.