How much rates vary
Facilitymedian $65 · 10th to 90th $55 to $107Professionalmedian $58 · 10th to 90th $28 to $2,455
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $50.12 Median $57.54 Typical High $57.54 | Professional | None | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $25.12 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.00 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $5.75 |
BCBS Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $107.15 | Facility | None | $53.70 | $64.57 | $107.15 |
BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $57.54 Typical High $83.18 | Facility | None | $53.70 | $57.54 | $83.18 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $70.79 | Professional | None | $52.48 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $26.92 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.72 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.37 | $5.75 | $5.75 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | None | $6.76 | $6.76 | $7.94 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $4,073.80 | Facility | None | $85.11 | $85.11 | $4,073.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.98 Median $85.11 Typical High $4,786.30 | Professional | None | $16.98 | $85.11 | $4,786.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $97.72 | Facility | None | $63.10 | $64.57 | $97.72 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $67.61 Typical High $87.10 | Facility | None | $61.66 | $67.61 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $131.83 | Professional | None | $58.88 | $67.61 | $131.83 |
United Setting Professional Modifier None Typical Low $10.96 Median $27.54 Typical High $29.51 | Professional | None | $10.96 | $27.54 | $29.51 |
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 Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $48.98 | $48.98 | $51.29 |
Where Idaho sits
The same service costs 2.8 times more in Hawaii than in Utah. 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
$57.54
HI $81.28UT $28.84
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.