How much rates vary
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 $60.26 Median $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.02 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $6.92 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | None | $69.18 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $97.72 | Facility | None | $60.26 | $67.61 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.02 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $6.92 |
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 $52.48 Median $58.88 Typical High $85.11 | Facility | None | $52.48 | $58.88 | $85.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $100.00 | Professional | None | $52.48 | $61.66 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | None | $70.79 | $72.44 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $44.67 Median $47.86 Typical High $48.98 | Facility | None | $44.67 | $47.86 | $48.98 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $89.13 | Professional | None | $39.81 | $47.86 | $89.13 |
United Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $97.72 | Professional | None | $54.95 | $70.79 | $97.72 |
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 $48.98 Median $48.98 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $48.98 | $48.98 | $60.26 |
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· 5th of 51
$69.18
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.