How much rates vary
Facilitymedian $105 · 10th to 90th $91 to $174Professionalmedian $93 · 10th to 90th $47 to $3,981
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 $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $173.78 | Facility | None | $87.10 | $104.71 | $173.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $93.33 Typical High $134.90 | Facility | None | $87.10 | $93.33 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | None | $87.10 | $93.33 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $9.33 |
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 $138.04 Median $138.04 Typical High $6,606.93 | Facility | None | $138.04 | $138.04 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $27.54 Median $138.04 Typical High $7,762.47 | Professional | None | $27.54 | $138.04 | $7,762.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $158.49 | Facility | None | $102.33 | $104.71 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $141.25 | Facility | None | $104.71 | $109.65 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $213.80 | Professional | None | $93.33 | $109.65 | $213.80 |
United Setting Professional Modifier None Typical Low $15.14 Median $47.86 Typical High $51.29 | Professional | None | $15.14 | $47.86 | $51.29 |
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 $79.43 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $83.18 |
Where Idaho sits
The same service costs 2.6 times more in North Carolina than in New York. 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· 10th of 51
$93.33
NC $126NY $47.86
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.