How much rates vary
Facilitymedian $129 · 10th to 90th $26 to $603Professionalmedian $72 · 10th to 90th $26 to $145
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 Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $144.54 | Professional | None | $30.90 | $50.12 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $24.55 Typical High $72.44 | Professional | 52 · Reduced service | $15.49 | $24.55 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.00 Typical High $28.84 | Professional | 53 · Discontinued | $6.17 | $10.00 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.41 Typical High $21.88 | Professional | 55 · Aftercare only | $4.68 | $7.41 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.01 Typical High $14.45 | Professional | 56 · Pre-op care only | $3.09 | $5.01 | $14.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $114.82 Median $346.74 Typical High $630.96 | Facility | None | $114.82 | $346.74 | $630.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $169.82 | Professional | None | $31.62 | $42.66 | $169.82 |
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 $25.70 Median $42.66 Typical High $151.36 | Facility | None | $25.70 | $42.66 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $144.54 | Professional | None | $31.62 | $53.70 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $24.55 Typical High $72.44 | Professional | 52 · Reduced service | $15.49 | $24.55 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.00 Typical High $28.84 | Professional | 53 · Discontinued | $6.17 | $10.00 | $28.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.41 Typical High $21.88 | Professional | 55 · Aftercare only | $4.68 | $7.41 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.01 Typical High $14.45 | Professional | 56 · Pre-op care only | $3.09 | $5.01 | $14.45 |
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 $20.42 Median $33.11 Typical High $128.82 | Facility | None | $20.42 | $33.11 | $128.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $20.42 Median $38.90 Typical High $144.54 | Professional | None | $20.42 | $38.90 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $14.45 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $14.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.30 Median $64.57 Typical High $125.89 | Professional | None | $26.30 | $64.57 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $77.62 Typical High $151.36 | Facility | None | $75.86 | $77.62 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $20.89 Median $39.81 Typical High $75.86 | Professional | None | $20.89 | $39.81 | $75.86 |
United Setting Professional Modifier None Typical Low $24.55 Median $58.88 Typical High $117.49 | Professional | None | $24.55 | $58.88 | $117.49 |
3 more rates 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 $25.12 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $25.12 | $102.33 | $120.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $102.33 | Professional | 54 · Surgery only | $26.92 | $26.92 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $28.84 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $28.84 | $28.84 | $109.65 |
Where Idaho sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 13th of 51
$74.13
AK $138IN $21.38
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.