How much rates vary
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 $107.15 Median $181.97 Typical High $181.97 | Professional | None | $107.15 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $18.20 | $18.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $269.15 | Professional | None | $190.55 | $229.09 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $181.97 Typical High $257.04 | Facility | None | $107.15 | $181.97 | $257.04 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $223.87 | Professional | None | $107.15 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $18.20 | $18.20 |
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 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $199.53 | Professional | None | $169.82 | $190.55 | $199.53 |
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 $117.49 Median $131.83 Typical High $281.84 | Professional | None | $117.49 | $131.83 | $281.84 |
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 83.2 times more in North Dakota than in Kansas. 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· 4th of 51
$182
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.