How much rates vary
Facilitymedian $158 · 10th to 90th $120 to $214Professionalmedian $126 · 10th to 90th $112 to $219
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 $112.20 Median $125.89 Typical High $125.89 | Professional | None | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | None | $151.36 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $213.80 | Facility | None | $144.54 | $158.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $181.97 | Facility | None | $102.33 | $125.89 | $181.97 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $223.87 | Professional | None | $112.20 | $125.89 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $22.39 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.60 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Facility | None | $147.91 | $147.91 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $213.80 | Professional | None | $125.89 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $158.49 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $186.21 |
Where Idaho sits
The same service costs 2.4 times more in Wyoming than in North Carolina. 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· 13th of 51
$126
WY $229NC $95.50
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.