How much rates vary
Facilitymedian $9 · 10th to 90th $7 to $309Professionalmedian $9 · 10th to 90th $3 to $11
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 $4.68 Median $11.22 Typical High $11.22 | Professional | None | $4.68 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $2.34 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $0.93 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.71 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.47 | $1.12 | $1.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $5.25 Median $7.76 Typical High $14.13 | Facility | None | $5.25 | $7.76 | $14.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $5.89 Median $8.91 Typical High $9.33 | Professional | None | $5.89 | $8.91 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Moda Health Setting Facility Modifier None Typical Low $7.41 Median $7.94 Typical High $11.22 | Facility | None | $7.41 | $7.94 | $11.22 |
Moda Health Setting Professional Modifier None Typical Low $4.68 Median $8.91 Typical High $11.22 | Professional | None | $4.68 | $8.91 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $2.34 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $0.93 | $2.24 | $2.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.71 | $1.70 | $1.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.47 | $1.12 | $1.12 |
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 $10.47 Median $309.03 Typical High $501.19 | Facility | None | $10.47 | $309.03 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.91 Median $10.47 Typical High $588.84 | Professional | None | $8.91 | $10.47 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.91 | Professional | None | $5.89 | $5.89 | $8.91 |
Select Health Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $10.72 | Facility | None | $8.32 | $8.32 | $10.72 |
Select Health Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $19.50 | Professional | None | $8.32 | $9.12 | $19.50 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.47 Typical High $5.37 | Professional | None | $2.75 | $3.47 | $5.37 |
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 $5.50 Median $6.17 Typical High $6.46 | Professional | 78 · Unplanned return to OR | $5.50 | $6.17 | $6.46 |
Where Idaho sits
The same service costs 2.6 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
$8.91
HI $9.12UT $3.47
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.