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 $66.07 Median $74.13 Typical High $74.13 | Professional | None | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $7.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | None | $112.20 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $74.13 Typical High $104.71 | Facility | None | $66.07 | $74.13 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | None | $66.07 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $7.41 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $77.62 | Professional | None | $30.20 | $30.20 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $85.11 Median $97.72 Typical High $138.04 | Facility | None | $85.11 | $97.72 | $138.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $162.18 | Professional | None | $85.11 | $100.00 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $77.62 Typical High $79.43 | Facility | None | $72.44 | $77.62 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $141.25 | Professional | None | $64.57 | $77.62 | $141.25 |
United Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $147.91 | Professional | None | $85.11 | $107.15 | $147.91 |
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 $77.62 Median $77.62 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $77.62 | $77.62 | $97.72 |
Where Idaho sits
The same service costs 2.2 times more in Alaska 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· 6th of 51
$112
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.