How much rates vary
Facilitymedian $229 · 10th to 90th $115 to $398Professionalmedian $123 · 10th to 90th $66 to $214
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 $100.00 Median $123.03 Typical High $194.98 | Professional | None | $100.00 | $123.03 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $60.26 Typical High $97.72 | Professional | 52 · Reduced service | $50.12 | $60.26 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $29.51 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.30 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.00 | $12.30 | $19.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $138.04 Median $257.04 Typical High $416.87 | Facility | None | $138.04 | $257.04 | $416.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $190.55 | Professional | None | $100.00 | $169.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $177.83 | Professional | None | $50.12 | $95.50 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $199.53 | Facility | None | $102.33 | $173.78 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $213.80 | Professional | None | $102.33 | $138.04 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $60.26 Typical High $97.72 | Professional | 52 · Reduced service | $50.12 | $60.26 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $29.51 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $19.50 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $229.09 | Facility | None | $114.82 | $114.82 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $229.09 | Professional | None | $109.65 | $181.97 | $229.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $18.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $436.52 | Facility | None | $229.09 | $331.13 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $181.97 | Professional | None | $66.07 | $123.03 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $138.04 | Facility | None | $114.82 | $120.23 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $138.04 | Professional | None | $72.44 | $89.13 | $138.04 |
United Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $162.18 | Professional | None | $54.95 | $95.50 | $162.18 |
3 more rates 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 $77.62 Median $81.28 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $128.82 | Professional | 54 · Surgery only | $77.62 | $77.62 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $138.04 |
Where Idaho sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 7th of 51
$123
AK $263NC $61.66
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.