How much rates vary
Facilitymedian $135 · 10th to 90th $44 to $214Professionalmedian $62 · 10th to 90th $38 to $151
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 $33.88 Median $69.18 Typical High $117.49 | Professional | None | $33.88 | $69.18 | $117.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $223.87 | Facility | None | $102.33 | $141.25 | $223.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $42.66 Median $104.71 Typical High $177.83 | Professional | None | $42.66 | $104.71 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $131.83 | Professional | None | $38.02 | $75.86 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $58.88 Typical High $120.23 | Facility | None | $40.74 | $58.88 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $147.91 | Professional | None | $38.02 | $83.18 | $147.91 |
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 $43.65 Median $43.65 Typical High $151.36 | Facility | None | $43.65 | $43.65 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $154.88 | Professional | None | $43.65 | $97.72 | $154.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $229.09 | Facility | None | $120.23 | $173.78 | $229.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $147.91 | Professional | None | $42.66 | $85.11 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $158.49 | Facility | None | $79.43 | $79.43 | $158.49 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $104.71 | Professional | None | $44.67 | $79.43 | $104.71 |
United Setting Professional Modifier None Typical Low $31.62 Median $67.61 Typical High $134.90 | Professional | None | $31.62 | $67.61 | $134.90 |
12 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 $16.98 Median $34.67 Typical High $58.88 | Professional | 52 · Reduced service | $16.98 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $13.80 Typical High $23.44 | Professional | 53 · Discontinued | $6.76 | $13.80 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $10.47 Typical High $17.78 | Professional | 55 · Aftercare only | $5.01 | $10.47 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $6.92 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.39 | $6.92 | $11.75 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $37.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $31.62 | $37.15 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $34.67 Typical High $58.88 | Professional | 52 · Reduced service | $18.20 | $34.67 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $23.44 | Professional | 53 · Discontinued | $7.41 | $13.80 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.47 Typical High $17.78 | Professional | 55 · Aftercare only | $5.50 | $10.47 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.92 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.72 | $6.92 | $11.75 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $91.20 | Professional | 54 · Surgery only | $31.62 | $31.62 | $91.20 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $12.88 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $33.88 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $33.88 | $33.88 | $97.72 |
Where Idaho sits
The same service costs 3.6 times more in North Carolina 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· 26th of 51
$79.43
NC $123DC $33.88
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.