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 $120.23 Median $131.83 Typical High $131.83 | Professional | None | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.02 | $13.18 | $13.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | None | $144.54 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $190.55 | Facility | None | $120.23 | $131.83 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | None | $120.23 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $60.26 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.02 | $13.18 | $13.18 |
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 $107.15 Median $123.03 Typical High $173.78 | Facility | None | $107.15 | $123.03 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $204.17 | Professional | None | $107.15 | $125.89 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | None | $147.91 | $154.88 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $100.00 | Facility | None | $91.20 | $97.72 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $186.21 | Professional | None | $85.11 | $100.00 | $186.21 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $190.55 | Professional | None | $109.65 | $141.25 | $190.55 |
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 $102.33 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $128.82 |
Where Idaho sits
The same service costs 2.5 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
$145
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.