How much rates vary
Facilitymedian $22 · 10th to 90th $19 to $35Professionalmedian $19 · 10th to 90th $9 to $794
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 $17.38 Median $18.62 Typical High $18.62 | Professional | None | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.47 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.57 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.74 | $1.86 | $1.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.78 Median $20.89 Typical High $34.67 | Facility | None | $17.78 | $20.89 | $34.67 |
BCBS Idaho Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $18.62 Typical High $26.92 | Facility | None | $17.38 | $18.62 | $26.92 |
Moda Health Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $22.91 | Professional | None | $17.38 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.71 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.47 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.63 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.74 | $1.86 | $1.86 |
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 $1,318.26 | Facility | None | $27.54 | $27.54 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.50 Median $27.54 Typical High $1,548.82 | Professional | None | $5.50 | $27.54 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $20.42 Median $20.89 Typical High $31.62 | Facility | None | $20.42 | $20.89 | $31.62 |
Select Health Setting Facility Modifier None Typical Low $21.38 Median $21.88 Typical High $28.18 | Facility | None | $21.38 | $21.88 | $28.18 |
Select Health Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $42.66 | Professional | None | $20.89 | $21.88 | $42.66 |
United Setting Professional Modifier None Typical Low $6.03 Median $9.12 Typical High $10.00 | Professional | None | $6.03 | $9.12 | $10.00 |
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 $15.85 Median $15.85 Typical High $16.60 | Professional | 78 · Unplanned return to OR | $15.85 | $15.85 | $16.60 |
Where Idaho sits
The same service costs 3.2 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· 8th of 51
$18.62
MT $26.92NY $8.32
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.