How much rates vary
Facilitymedian $21 · 10th to 90th $17 to $39Professionalmedian $24 · 10th to 90th $20 to $27
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 $19.05 Median $23.44 Typical High $23.44 | Professional | None | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $9.55 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.80 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.88 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.91 | $2.34 | $2.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $33.88 Median $40.74 Typical High $47.86 | Facility | None | $33.88 | $40.74 | $47.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $26.92 | Professional | None | $25.12 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $23.44 Typical High $33.88 | Facility | None | $19.05 | $23.44 | $33.88 |
Moda Health Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | None | $19.05 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $9.55 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.80 | $4.68 | $4.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.88 | $3.55 | $3.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.91 | $2.34 | $2.34 |
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 $18.62 Median $21.38 Typical High $30.20 | Facility | None | $18.62 | $21.38 | $30.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $35.48 | Professional | None | $18.62 | $21.88 | $35.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | None | $23.99 | $26.92 | $26.92 |
Select Health Setting Facility Modifier None Typical Low $15.85 Median $16.98 Typical High $17.38 | Facility | None | $15.85 | $16.98 | $17.38 |
Select Health Setting Professional Modifier None Typical Low $14.79 Median $16.98 Typical High $32.36 | Professional | None | $14.79 | $16.98 | $32.36 |
United Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $33.11 | Professional | None | $19.05 | $24.55 | $33.11 |
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 $17.78 Median $17.78 Typical High $22.39 | Professional | 78 · Unplanned return to OR | $17.78 | $17.78 | $22.39 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Indiana. 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
$23.99
AK $37.15IN $13.49
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.