How much rates vary
Facilitymedian $32 · 10th to 90th $25 to $1,413Professionalmedian $27 · 10th to 90th $13 to $36
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 $15.14 Median $36.31 Typical High $36.31 | Professional | None | $15.14 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $7.41 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $3.02 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $2.24 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.51 | $3.63 | $3.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $23.99 Median $38.02 Typical High $46.77 | Facility | None | $23.99 | $38.02 | $46.77 |
BCBS Idaho Setting Professional Modifier None Typical Low $18.20 Median $30.20 Typical High $31.62 | Professional | None | $18.20 | $30.20 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $24.55 Typical High $36.31 | Facility | None | $15.14 | $24.55 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $15.14 Median $26.92 Typical High $36.31 | Professional | None | $15.14 | $26.92 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $7.41 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $3.02 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $2.24 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.51 | $3.63 | $3.63 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | None | $20.89 | $24.55 | $24.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $32.36 Median $954.99 Typical High $1,548.82 | Facility | None | $32.36 | $954.99 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $1,819.70 | Professional | None | $26.92 | $32.36 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $26.92 | Professional | None | $18.20 | $18.20 | $26.92 |
Select Health Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $26.30 | Facility | None | $25.70 | $25.70 | $26.30 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $60.26 | Professional | None | $25.70 | $28.18 | $60.26 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $14.45 | Professional | None | $9.77 | $13.18 | $14.45 |
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 $19.05 Median $21.38 Typical High $22.39 | Professional | 78 · Unplanned return to OR | $19.05 | $21.38 | $22.39 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii 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· 4th of 51
$26.92
HI $32.36KY $12.30
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.