How much rates vary
Facilitymedian $158 · 10th to 90th $117 to $209Professionalmedian $126 · 10th to 90th $45 to $209
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 $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | 54 · Surgery only | $33.88 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $17.78 | Facility | None | $16.98 | $16.98 | $17.78 |
BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $151.36 | Professional | None | $30.90 | $30.90 | $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 $45.71 Median $45.71 Typical High $66.07 | Facility | None | $45.71 | $45.71 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $223.87 | Professional | None | $45.71 | $45.71 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.39 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | 54 · Surgery only | $33.88 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.76 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
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 $128.82 Median $147.91 Typical High $208.93 | Facility | None | $128.82 | $147.91 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $245.47 | Professional | None | $128.82 | $147.91 | $245.47 |
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 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 6.3 times more in North Dakota than in Hawaii. 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
ND $182HI $28.84
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.