How much rates vary
Facilitymedian $158 · 10th to 90th $54 to $214Professionalmedian $126 · 10th to 90th $37 to $200
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 $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $151.36 | Professional | None | $37.15 | $37.15 | $151.36 |
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 $33.88 Median $42.66 Typical High $60.26 | Facility | None | $33.88 | $42.66 | $60.26 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $223.87 | Professional | None | $37.15 | $42.66 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $26.30 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $26.30 | $177.83 | $186.21 |
Where Idaho sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 16th of 51
$126
ND $141MD $33.88
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.