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 $151.36 Median $154.88 Typical High $154.88 | Professional | None | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $15.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $416.87 | Facility | None | $169.82 | $173.78 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $223.87 | Facility | None | $151.36 | $154.88 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | None | $151.36 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $15.49 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $91.20 Median $102.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $91.20 | $102.33 | $107.15 |
Where Idaho sits
The same service costs 2.2 times more in North Carolina than in Michigan. 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· 18th of 51
$155
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.