How much rates vary
Facilitymedian $195 · 10th to 90th $158 to $282Professionalmedian $229 · 10th to 90th $200 to $234
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 $199.53 Median $223.87 Typical High $223.87 | Professional | None | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $39.81 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $22.39 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | None | $229.09 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $323.59 | Facility | None | $199.53 | $223.87 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | None | $199.53 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $100.00 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $39.81 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $22.39 |
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 $173.78 Median $194.98 Typical High $281.84 | Facility | None | $173.78 | $194.98 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $331.13 | Professional | None | $173.78 | $204.17 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $162.18 | Facility | None | $144.54 | $158.49 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $288.40 | Professional | None | $131.83 | $158.49 | $288.40 |
United Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $323.59 | Professional | None | $181.97 | $234.42 | $323.59 |
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 $158.49 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $199.53 |
Where Idaho sits
The same service costs 2.6 times more in Alaska than in Arizona. 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
$229
AK $316AZ $120
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.