How much rates vary
Facilitymedian $204 · 10th to 90th $78 to $1,202Professionalmedian $85 · 10th to 90th $59 to $170
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 $70.79 Median $85.11 Typical High $165.96 | Professional | None | $70.79 | $85.11 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $42.66 Typical High $83.18 | Professional | 52 · Reduced service | $34.67 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $33.11 | Professional | 53 · Discontinued | $14.13 | $16.98 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $25.12 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $16.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $645.65 Typical High $1,318.26 | Facility | None | $128.82 | $645.65 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $154.88 | Professional | None | $67.61 | $97.72 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $151.36 | Professional | None | $43.65 | $79.43 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $165.96 | Facility | None | $70.79 | $100.00 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $177.83 | Professional | None | $74.13 | $89.13 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $42.66 Typical High $83.18 | Professional | 52 · Reduced service | $34.67 | $42.66 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $33.11 | Professional | 53 · Discontinued | $14.13 | $16.98 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $25.12 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $16.60 |
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 $77.62 Median $77.62 Typical High $177.83 | Facility | None | $77.62 | $77.62 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $177.83 | Professional | None | $75.86 | $151.36 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $15.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,318.26 | Facility | None | $524.81 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $177.83 | Professional | None | $67.61 | $89.13 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $204.17 | Facility | None | $93.33 | $95.50 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $295.12 | Professional | None | $52.48 | $93.33 | $295.12 |
United Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $134.90 | Professional | None | $30.20 | $72.44 | $134.90 |
4 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 $52.48 Median $54.95 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $52.48 | $54.95 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $104.71 | Professional | 54 · Surgery only | $53.70 | $53.70 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $112.20 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 14th of 51
$87.10
AK $155MD $54.95
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.