How much rates vary
Facilitymedian $112 · 10th to 90th $66 to $257Professionalmedian $93 · 10th to 90th $81 to $112
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $81.28 Median $81.28 Typical High $93.33 | Professional | None | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $234.42 Median $257.04 Typical High $257.04 | Facility | None | $234.42 | $257.04 | $257.04 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | None | $85.11 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $100.00 | Professional | None | $70.79 | $87.10 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $117.49 | Facility | None | $81.28 | $81.28 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | None | $81.28 | $81.28 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $40.74 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $16.22 | $16.22 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.33 |
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 $112.20 Median $125.89 Typical High $125.89 | Facility | None | $112.20 | $125.89 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | None | $120.23 | $120.23 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | None | $104.71 | $104.71 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $67.61 | Facility | None | $61.66 | $66.07 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $102.33 | Professional | None | $53.70 | $67.61 | $102.33 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $100.00 | Professional | None | $56.23 | $75.86 | $100.00 |
1 more rate 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 $60.26 Median $60.26 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $74.13 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 9th of 51
$93.33
AK $132KY $40.74
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.