How much rates vary
Facilitymedian $98 · 10th to 90th $78 to $138Professionalmedian $112 · 10th to 90th $91 to $117
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 $91.20 Median $104.71 Typical High $104.71 | Professional | None | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $10.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | None | $112.20 | $117.49 | $117.49 |
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 $91.20 Median $104.71 Typical High $147.91 | Facility | None | $91.20 | $104.71 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | None | $91.20 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $45.71 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $18.20 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $10.47 |
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 $85.11 Median $97.72 Typical High $138.04 | Facility | None | $85.11 | $97.72 | $138.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $162.18 | Professional | None | $85.11 | $100.00 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $77.62 Typical High $79.43 | Facility | None | $72.44 | $77.62 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $141.25 | Professional | None | $64.57 | $77.62 | $141.25 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $147.91 | Professional | None | $85.11 | $109.65 | $147.91 |
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 $77.62 Median $77.62 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $77.62 | $77.62 | $97.72 |
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
$112
AK $155AZ $60.26
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.