How much rates vary
Facilitymedian $148 · 10th to 90th $117 to $347Professionalmedian $170 · 10th to 90th $126 to $372
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 $218.78 Median $371.54 Typical High $371.54 | Professional | None | $218.78 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $109.65 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $43.65 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.88 | $37.15 | $37.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $323.59 | Facility | None | $141.25 | $144.54 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $371.54 Typical High $524.81 | Facility | None | $117.49 | $371.54 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $371.54 | Professional | None | $204.17 | $257.04 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $109.65 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $43.65 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.88 | $37.15 | $37.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $208.93 | Facility | None | $128.82 | $147.91 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $245.47 | Professional | None | $128.82 | $147.91 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $213.80 | Professional | None | $125.89 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $158.49 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $186.21 |
Where Idaho sits
The same service costs 2.9 times more in Alaska than in North Carolina. 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· 14th of 51
$166
AK $339NC $117
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.