How much rates vary
Facilitymedian $204 · 10th to 90th $91 to $389Professionalmedian $98 · 10th to 90th $68 to $195
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 $79.43 Median $97.72 Typical High $190.55 | Professional | None | $79.43 | $97.72 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $48.98 Typical High $95.50 | Professional | 52 · Reduced service | $39.81 | $48.98 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $38.90 | Professional | 53 · Discontinued | $16.22 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $28.84 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $19.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $218.78 Typical High $407.38 | Facility | None | $77.62 | $218.78 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $186.21 | Professional | None | $81.28 | $114.82 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $173.78 | Professional | None | $50.12 | $91.20 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $107.15 Typical High $190.55 | Facility | None | $81.28 | $107.15 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $204.17 | Professional | None | $97.72 | $104.71 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $48.98 Typical High $95.50 | Professional | 52 · Reduced service | $39.81 | $48.98 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $38.90 | Professional | 53 · Discontinued | $16.22 | $19.50 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $28.84 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $19.05 |
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 $91.20 Median $91.20 Typical High $204.17 | Facility | None | $91.20 | $91.20 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $204.17 | Professional | None | $89.13 | $177.83 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $17.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $416.87 | Facility | None | $218.78 | $309.03 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $204.17 | Professional | None | $81.28 | $104.71 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $114.82 | Professional | None | $63.10 | $87.10 | $114.82 |
United Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $154.88 | Professional | None | $30.20 | $83.18 | $154.88 |
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 $63.10 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $63.10 | $125.89 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $125.89 | Professional | 54 · Surgery only | $63.10 | $63.10 | $125.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $67.61 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $67.61 | $67.61 | $134.90 |
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· 13th of 51
$102
AK $178MD $64.57
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.