How much rates vary
Facilitymedian $19 · 10th to 90th $17 to $31Professionalmedian $17 · 10th to 90th $9 to $724
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 $15.85 Median $16.98 Typical High $16.98 | Professional | None | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.16 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.34 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.58 | $1.70 | $1.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.22 Median $18.62 Typical High $30.90 | Facility | None | $16.22 | $18.62 | $30.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Moda Health Setting Facility Modifier None Typical Low $15.85 Median $16.98 Typical High $23.99 | Facility | None | $15.85 | $16.98 | $23.99 |
Moda Health Setting Professional Modifier None Typical Low $15.85 Median $16.98 Typical High $20.42 | Professional | None | $15.85 | $16.98 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.16 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.34 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.58 | $1.70 | $1.70 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $13.18 Typical High $30.20 | Professional | None | $11.22 | $13.18 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $1,174.90 | Facility | None | $24.55 | $24.55 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4.90 Median $24.55 Typical High $1,380.38 | Professional | None | $4.90 | $24.55 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $18.20 Median $18.62 Typical High $28.18 | Facility | None | $18.20 | $18.62 | $28.18 |
Select Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $26.30 | Facility | None | $19.50 | $19.50 | $26.30 |
Select Health Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $38.90 | Professional | None | $19.05 | $21.38 | $38.90 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $9.55 | Professional | None | $7.59 | $9.12 | $9.55 |
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 $14.45 Median $14.45 Typical High $15.14 | Professional | 78 · Unplanned return to OR | $14.45 | $14.45 | $15.14 |
Where Idaho sits
The same service costs 4.2 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· 13th of 51
$16.98
HI $36.31NY $8.71
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.