How much rates vary
Facilitymedian $162 · 10th to 90th $32 to $389Professionalmedian $41 · 10th to 90th $28 to $135
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 $27.54 Median $60.26 Typical High $125.89 | Professional | None | $27.54 | $60.26 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $30.20 Typical High $63.10 | Professional | 52 · Reduced service | $13.80 | $30.20 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $12.30 Typical High $25.12 | Professional | 53 · Discontinued | $5.50 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $9.12 Typical High $19.05 | Professional | 55 · Aftercare only | $4.07 | $9.12 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $6.03 Typical High $12.59 | Professional | 56 · Pre-op care only | $2.75 | $6.03 | $12.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $407.38 | Facility | None | $128.82 | $218.78 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $27.54 Median $109.65 Typical High $123.03 | Professional | None | $27.54 | $109.65 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $39.81 Typical High $112.20 | Professional | None | $16.98 | $39.81 | $112.20 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $47.86 Typical High $125.89 | Facility | None | $28.84 | $47.86 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $138.04 | Professional | None | $33.88 | $67.61 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $16.98 Typical High $63.10 | Professional | 52 · Reduced service | $13.80 | $16.98 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.76 Typical High $25.12 | Professional | 53 · Discontinued | $5.50 | $6.76 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.13 Typical High $19.05 | Professional | 55 · Aftercare only | $4.07 | $5.13 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.39 Typical High $12.59 | Professional | 56 · Pre-op care only | $2.75 | $3.39 | $12.59 |
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 $32.36 Median $32.36 Typical High $138.04 | Facility | None | $32.36 | $32.36 | $138.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $31.62 Median $117.49 Typical High $138.04 | Professional | None | $31.62 | $117.49 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $11.75 |
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 $27.54 Median $89.13 Typical High $138.04 | Professional | None | $27.54 | $89.13 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $194.98 | Facility | None | $74.13 | $75.86 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $87.10 | Professional | None | $21.88 | $33.11 | $87.10 |
United Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $102.33 | Professional | None | $22.91 | $35.48 | $102.33 |
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 $22.91 Median $28.18 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $22.91 | $28.18 | $100.00 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $83.18 | Professional | 54 · Surgery only | $21.38 | $21.38 | $83.18 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $22.91 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $22.91 | $22.91 | $89.13 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 30th of 51
$46.77
HI $110DC $25.12
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.