How much rates vary
Facilitymedian $174 · 10th to 90th $49 to $389Professionalmedian $58 · 10th to 90th $39 to $166
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 $41.69 Median $75.86 Typical High $158.49 | Professional | None | $41.69 | $75.86 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $38.02 Typical High $79.43 | Professional | 52 · Reduced service | $20.89 | $38.02 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.14 Typical High $31.62 | Professional | 53 · Discontinued | $8.32 | $15.14 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.22 Typical High $23.44 | Professional | 55 · Aftercare only | $6.17 | $11.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $4.17 | $7.59 | $15.85 |
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 $41.69 Median $134.90 Typical High $151.36 | Professional | None | $41.69 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $58.88 Typical High $141.25 | Professional | None | $25.70 | $58.88 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $158.49 | Facility | None | $44.67 | $72.44 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $169.82 | Professional | None | $51.29 | $85.11 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $25.70 Typical High $79.43 | Professional | 52 · Reduced service | $21.88 | $25.70 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.23 Typical High $31.62 | Professional | 53 · Discontinued | $8.71 | $10.23 | $31.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.76 Typical High $23.44 | Professional | 55 · Aftercare only | $6.61 | $7.76 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $4.37 | $5.13 | $15.85 |
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 $48.98 Median $48.98 Typical High $173.78 | Facility | None | $48.98 | $48.98 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $144.54 Typical High $173.78 | Professional | None | $46.77 | $144.54 | $173.78 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $14.45 |
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 $41.69 Median $109.65 Typical High $169.82 | Professional | None | $41.69 | $109.65 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $177.83 | Facility | None | $91.20 | $93.33 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $91.20 | Professional | None | $32.36 | $50.12 | $91.20 |
United Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $125.89 | Professional | None | $30.20 | $46.77 | $125.89 |
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 $32.36 Median $34.67 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $32.36 | $34.67 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $102.33 | Professional | 54 · Surgery only | $32.36 | $32.36 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $34.67 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $34.67 | $34.67 | $109.65 |
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 3.5 times more in Hawaii 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· 31st of 51
$60.26
HI $135MD $38.02
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.