How much rates vary
Facilitymedian $158 · 10th to 90th $141 to $257Professionalmedian $151 · 10th to 90th $126 to $3,467
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 $3,090.30 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,090.30 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,548.82 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $309.03 | $346.74 | $346.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $3,548.13 Typical High $3,548.13 | Professional | None | $151.36 | $3,548.13 | $3,548.13 |
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 $2,754.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,754.23 | $3,467.37 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $3,090.30 Typical High $3,467.37 | Professional | None | $208.93 | $3,090.30 | $3,467.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,548.82 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $616.60 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $457.09 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $309.03 | $346.74 | $346.74 |
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 $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 37.2 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· 26th of 51
$151
WY $3,548NC $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.