How much rates vary
Facilitymedian $148 · 10th to 90th $126 to $5,370Professionalmedian $138 · 10th to 90th $59 to $5,370
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 $117.49 Median $125.89 Typical High $125.89 | Professional | None | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $23.44 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.78 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $12.59 |
BCBS Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $229.09 | Facility | None | $120.23 | $141.25 | $229.09 |
BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $125.89 Typical High $177.83 | Facility | None | $117.49 | $125.89 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $151.36 | Professional | None | $120.23 | $125.89 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $58.88 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $23.44 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.78 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $12.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $8,709.64 | Facility | None | $181.97 | $181.97 | $8,709.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $36.31 Median $181.97 Typical High $10,232.93 | Professional | None | $36.31 | $181.97 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Facility | None | $144.54 | $144.54 | $147.91 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $288.40 | Professional | None | $141.25 | $144.54 | $288.40 |
United Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $67.61 | Professional | None | $47.86 | $60.26 | $67.61 |
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 $107.15 Median $107.15 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $112.20 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii 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· 5th of 51
$138
HI $178NY $58.88
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.