How much rates vary
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 $33.11 Median $33.88 Typical High $33.88 | Professional | None | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.61 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.31 | $3.39 | $3.39 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $89.13 | Facility | None | $36.31 | $37.15 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Moda Health Setting Facility Modifier None Typical Low $10.00 Median $33.88 Typical High $47.86 | Facility | None | $10.00 | $33.88 | $47.86 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | None | $33.11 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.61 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.31 | $3.39 | $3.39 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $19.95 Median $21.88 Typical High $23.44 | Professional | 78 · Unplanned return to OR | $19.95 | $21.88 | $23.44 |
Where Idaho sits
The same service costs 5.6 times more in Alaska 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· 9th of 51
$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.