How much rates vary
Facilitymedian $269 · 10th to 90th $141 to $661Professionalmedian $166 · 10th to 90th $138 to $219
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 $128.82 Median $151.36 Typical High $151.36 | Professional | None | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $15.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $660.69 | Facility | None | $194.98 | $323.59 | $660.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $229.09 | Professional | None | $158.49 | $194.98 | $229.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $141.25 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | None | $144.54 | $169.82 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $151.36 Typical High $218.78 | Facility | None | $141.25 | $151.36 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $194.98 | Professional | None | $141.25 | $151.36 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.80 | $15.14 | $15.14 |
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 $173.78 Median $194.98 Typical High $194.98 | Facility | None | $173.78 | $194.98 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $199.53 | Professional | None | $169.82 | $194.98 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $194.98 | Professional | None | $138.04 | $158.49 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $346.74 | Facility | None | $102.33 | $102.33 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $165.96 | Professional | None | $102.33 | $128.82 | $165.96 |
United Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $208.93 | Professional | None | $117.49 | $162.18 | $208.93 |
6 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $69.18 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $20.89 | $22.91 | $22.91 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 10th of 51
$170
AK $282TX $100
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.