How much rates vary
Facilitymedian $22 · 10th to 90th $19 to $51Professionalmedian $19 · 10th to 90th $9 to $813
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 $16.60 Median $19.05 Typical High $19.05 | Professional | None | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $8.32 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.39 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.51 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.66 | $1.91 | $1.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.78 Median $21.38 Typical High $35.48 | Facility | None | $17.78 | $21.38 | $35.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Moda Health Setting Facility Modifier None Typical Low $17.78 Median $19.05 Typical High $27.54 | Facility | None | $17.78 | $19.05 | $27.54 |
Moda Health Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $23.44 | Professional | None | $17.78 | $19.05 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $8.51 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.39 | $3.80 | $3.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.57 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.70 | $1.91 | $1.91 |
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 $27.54 Median $27.54 Typical High $1,348.96 | Facility | None | $27.54 | $27.54 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.62 Median $27.54 Typical High $1,548.82 | Professional | None | $5.62 | $27.54 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $20.89 Median $21.38 Typical High $31.62 | Facility | None | $20.89 | $21.38 | $31.62 |
Select Health Setting Facility Modifier None Typical Low $20.42 Median $22.39 Typical High $28.84 | Facility | None | $20.42 | $22.39 | $28.84 |
Select Health Setting Professional Modifier None Typical Low $19.50 Median $22.39 Typical High $43.65 | Professional | None | $19.50 | $22.39 | $43.65 |
United Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $18.20 | Professional | None | $8.91 | $9.77 | $18.20 |
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 $16.22 Median $16.22 Typical High $16.98 | Professional | 78 · Unplanned return to OR | $16.22 | $16.22 | $16.98 |
Where Idaho sits
The same service costs 3.0 times more in Montana 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
$19.05
MT $25.12NY $8.51
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.