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 $3,981.07 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,981.07 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,995.26 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $398.11 | $416.87 | $416.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $11,220.18 | Facility | None | $4,466.84 | $4,677.35 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $2,951.21 Median $4,168.69 Typical High $5,888.44 | Facility | None | $2,951.21 | $4,168.69 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,073.80 | $4,168.69 | $4,168.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,041.74 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,041.74 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $812.83 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $407.38 | $416.87 | $416.87 |
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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $1,621.81 Median $1,819.70 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $1,905.46 |
Where Idaho sits
The same service costs 2.2 times more in Alaska than in South 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· 8th of 51
$4,169
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.