How much rates vary
Facilitymedian $214 · 10th to 90th $174 to $309Professionalmedian $245 · 10th to 90th $195 to $263
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 $194.98 Median $218.78 Typical High $218.78 | Professional | None | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $21.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | None | $245.47 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $316.23 | Facility | None | $194.98 | $218.78 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | None | $194.98 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $97.72 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.90 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $21.88 |
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 $190.55 Median $213.80 Typical High $309.03 | Facility | None | $190.55 | $213.80 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $363.08 | Professional | None | $190.55 | $223.87 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $177.83 | Facility | None | $162.18 | $173.78 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $309.03 | Professional | None | $141.25 | $173.78 | $309.03 |
United Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $316.23 | Professional | None | $181.97 | $234.42 | $316.23 |
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 $169.82 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $213.80 |
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
$245
AK $339AZ $132
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.