How much rates vary
Facilitymedian $23 · 10th to 90th $15 to $40Professionalmedian $21 · 10th to 90th $16 to $32
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 $18.20 Median $19.05 Typical High $19.95 | Professional | None | $18.20 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.33 Typical High $10.00 | Professional | 52 · Reduced service | $9.12 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.80 Typical High $4.07 | Professional | 53 · Discontinued | $3.63 | $3.80 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.82 Typical High $3.02 | Professional | 55 · Aftercare only | $2.75 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.91 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.82 | $1.91 | $2.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $19.50 Median $25.12 Typical High $39.81 | Facility | None | $19.50 | $25.12 | $39.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $37.15 | Professional | None | $22.91 | $26.92 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Moda Health Setting Facility Modifier None Typical Low $13.49 Median $19.05 Typical High $22.91 | Facility | None | $13.49 | $19.05 | $22.91 |
Moda Health Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $28.18 | Professional | None | $18.20 | $19.95 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.55 Typical High $10.00 | Professional | 52 · Reduced service | $9.12 | $9.55 | $10.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.80 Typical High $4.07 | Professional | 53 · Discontinued | $3.63 | $3.80 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.82 Typical High $3.02 | Professional | 55 · Aftercare only | $2.75 | $2.82 | $3.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.91 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.82 | $1.91 | $2.04 |
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 $13.18 Median $18.20 Typical High $27.54 | Facility | None | $13.18 | $18.20 | $27.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.18 Median $18.62 Typical High $29.51 | Professional | None | $13.18 | $18.62 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $25.12 Median $26.92 Typical High $39.81 | Facility | None | $25.12 | $26.92 | $39.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $25.12 | Professional | None | $17.78 | $22.91 | $25.12 |
Select Health Setting Facility Modifier None Typical Low $16.22 Median $16.60 Typical High $64.57 | Facility | None | $16.22 | $16.60 | $64.57 |
Select Health Setting Professional Modifier None Typical Low $14.13 Median $16.22 Typical High $28.18 | Professional | None | $14.13 | $16.22 | $28.18 |
United Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $26.92 | Professional | None | $15.85 | $20.42 | $26.92 |
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 $16.22 Median $19.05 Typical High $24.55 | Professional | 78 · Unplanned return to OR | $16.22 | $19.05 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $19.05 Typical High $20.42 | Professional | 54 · Surgery only | $19.05 | $19.05 | $20.42 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | 78 · Unplanned return to OR | $20.42 | $20.42 | $21.88 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in New York. 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· 15th of 51
$21.38
AK $39.81NY $12.30
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.