How much rates vary
Facilitymedian $145 · 10th to 90th $95 to $195Professionalmedian $126 · 10th to 90th $85 to $224
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 $83.18 Median $95.50 Typical High $95.50 | Professional | None | $83.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $9.55 | $9.55 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $288.40 Typical High $288.40 | Professional | None | $151.36 | $288.40 | $288.40 |
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 $75.86 Median $95.50 Typical High $134.90 | Facility | None | $75.86 | $95.50 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $223.87 | Professional | None | $83.18 | $95.50 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.60 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $9.55 | $9.55 |
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 3.8 times more in Wyoming than in Kentucky. 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· 24th of 51
$126
WY $288KY $75.86
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.