How much rates vary
Facilitymedian $26 · 10th to 90th $22 to $158Professionalmedian $22 · 10th to 90th $12 to $955
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 $20.89 Median $22.39 Typical High $22.39 | Professional | None | $20.89 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.17 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.09 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.04 | $2.24 | $2.24 |
BCBS Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $40.74 | Facility | None | $20.42 | $24.55 | $40.74 |
BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $22.39 Typical High $31.62 | Facility | None | $20.89 | $22.39 | $31.62 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $22.39 Typical High $26.92 | Professional | None | $20.89 | $22.39 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.23 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.17 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.09 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.09 | $2.24 | $2.24 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $30.20 | Professional | None | $21.38 | $25.12 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $1,548.82 | Facility | None | $32.36 | $32.36 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.46 Median $32.36 Typical High $1,819.70 | Professional | None | $6.46 | $32.36 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $23.99 Median $24.55 Typical High $37.15 | Facility | None | $23.99 | $24.55 | $37.15 |
Select Health Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $33.11 | Facility | None | $25.70 | $25.70 | $33.11 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $51.29 | Professional | None | $25.12 | $25.70 | $51.29 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $12.59 | Professional | None | $9.77 | $12.02 | $12.59 |
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 $19.05 Median $19.05 Typical High $19.95 | Professional | 78 · Unplanned return to OR | $19.05 | $19.05 | $19.95 |
Where Idaho sits
The same service costs 3.5 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· 11th of 51
$22.39
HI $37.15NY $10.72
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.