How much rates vary
Facilitymedian $107 · 10th to 90th $91 to $166Professionalmedian $145 · 10th to 90th $93 to $155
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 $87.10 Median $93.33 Typical High $93.33 | Professional | None | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $9.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | None | $144.54 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $93.33 Typical High $134.90 | Facility | None | $87.10 | $93.33 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | None | $87.10 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $9.33 |
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 $107.15 Median $123.03 Typical High $173.78 | Facility | None | $107.15 | $123.03 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $204.17 | Professional | None | $107.15 | $125.89 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | None | $147.91 | $154.88 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $100.00 | Facility | None | $91.20 | $97.72 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $186.21 | Professional | None | $85.11 | $100.00 | $186.21 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $190.55 | Professional | None | $109.65 | $141.25 | $190.55 |
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 $102.33 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $128.82 |
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
$145
AK $186KY $83.18
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.