How much rates vary
Facilitymedian $145 · 10th to 90th $25 to $195Professionalmedian $126 · 10th to 90th $22 to $204
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $21.88 Median $25.12 Typical High $25.12 | Professional | None | $21.88 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $10.96 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.37 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.19 | $2.51 | $2.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $151.36 | Professional | None | $22.39 | $22.39 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $323.59 | Facility | None | $141.25 | $144.54 | $323.59 |
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 $19.95 Median $25.12 Typical High $35.48 | Facility | None | $19.95 | $25.12 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $223.87 | Professional | None | $21.88 | $25.12 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $10.96 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.37 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.19 | $2.51 | $2.51 |
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 6.3 times more in Massachusetts than in Indiana. 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· 7th of 51
$126
MA $126IN $19.95
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.