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 $204.17 Median $204.17 Typical High $229.09 | Professional | None | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $22.91 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | None | $223.87 | $251.19 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $288.40 | Facility | None | $204.17 | $204.17 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | None | $204.17 | $204.17 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $22.91 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,513.56 Typical High $1,513.56 | Professional | None | $30.20 | $1,513.56 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $269.15 | Facility | None | $263.03 | $263.03 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $501.19 | Professional | None | $213.80 | $263.03 | $501.19 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $158.49 Median $173.78 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $158.49 | $173.78 | $186.21 |
Where Idaho sits
The same service costs 6.3 times more in Alaska than in New York. 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· 38th of 51
$204
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.