How much rates vary
Facilitymedian $229 · 10th to 90th $191 to $355Professionalmedian $295 · 10th to 90th $191 to $309
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 $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $275.42 | Facility | None | $173.78 | $190.55 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
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 $229.09 Median $257.04 Typical High $371.54 | Facility | None | $229.09 | $257.04 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | None | $229.09 | $269.15 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $208.93 | Facility | None | $190.55 | $208.93 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $371.54 | Professional | None | $169.82 | $208.93 | $371.54 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $389.05 | Professional | None | $223.87 | $288.40 | $389.05 |
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 $208.93 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $257.04 |
Where Idaho sits
The same service costs 2.2 times more in North Dakota 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
$295
ND $380KY $170
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.