How much rates vary
Facilitymedian $151 · 10th to 90th $123 to $219Professionalmedian $174 · 10th to 90th $141 to $186
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 $141.25 Median $158.49 Typical High $158.49 | Professional | None | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $70.79 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $28.18 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $15.85 |
BCBS Idaho Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | None | $173.78 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $229.09 | Facility | None | $141.25 | $158.49 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | None | $141.25 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $70.79 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $28.18 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $15.85 |
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 $134.90 Median $151.36 Typical High $218.78 | Facility | None | $134.90 | $151.36 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $257.04 | Professional | None | $134.90 | $158.49 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | None | $181.97 | $181.97 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $123.03 Typical High $125.89 | Facility | None | $114.82 | $123.03 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $223.87 | Professional | None | $100.00 | $123.03 | $223.87 |
United Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $229.09 | Professional | None | $131.83 | $165.96 | $229.09 |
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 $123.03 Median $123.03 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $151.36 |
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
$174
AK $240AZ $93.33
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.