How much rates vary
Facilitymedian $49 · 10th to 90th $37 to $1,622Professionalmedian $47 · 10th to 90th $15 to $59
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 $24.55 Median $58.88 Typical High $58.88 | Professional | None | $24.55 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $12.30 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $4.90 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $3.72 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.45 | $5.89 | $5.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $74.13 | Facility | None | $31.62 | $41.69 | $74.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $48.98 | Professional | None | $30.90 | $46.77 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $52.48 Typical High $58.88 | Facility | None | $38.90 | $52.48 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $46.77 Typical High $58.88 | Professional | None | $24.55 | $46.77 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $12.30 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $4.90 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $3.72 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.45 | $5.89 | $5.89 |
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 $54.95 Median $1,621.81 Typical High $2,630.27 | Facility | None | $54.95 | $1,621.81 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $3,090.30 | Professional | None | $46.77 | $54.95 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $46.77 | Professional | None | $30.90 | $30.90 | $46.77 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $56.23 | Facility | None | $43.65 | $43.65 | $56.23 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $102.33 | Professional | None | $43.65 | $47.86 | $102.33 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $28.84 Median $32.36 Typical High $33.88 | Professional | 78 · Unplanned return to OR | $28.84 | $32.36 | $33.88 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 2nd of 51
$46.77
HI $47.86UT $15.14
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.