How much rates vary
Facilitymedian $11 · 10th to 90th $6 to $52Professionalmedian $50 · 10th to 90th $11 to $52
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $51.29 Median $52.48 Typical High $52.48 | Professional | None | $51.29 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.23 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $5.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $5.50 Median $8.51 Typical High $26.30 | Facility | None | $5.50 | $8.51 | $26.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $52.48 | Professional | None | $33.11 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $141.25 | Facility | None | $57.54 | $72.44 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $8.91 Median $52.48 Typical High $74.13 | Facility | None | $8.91 | $52.48 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | None | $50.12 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $25.12 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.00 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.59 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.01 | $5.25 | $5.25 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $7.76 Typical High $7.76 | Professional | None | $6.61 | $7.76 | $7.76 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $8.91 Median $11.22 Typical High $11.22 | Facility | None | $8.91 | $11.22 | $11.22 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $9.77 Median $11.22 Typical High $11.22 | Professional | None | $9.77 | $11.22 | $11.22 |
Regence BlueShield Setting Facility Modifier None Typical Low $5.13 Median $6.92 Typical High $13.49 | Facility | None | $5.13 | $6.92 | $13.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
Select Health Setting Facility Modifier None Typical Low $9.77 Median $11.48 Typical High $11.48 | Facility | None | $9.77 | $11.48 | $11.48 |
Select Health Setting Professional Modifier None Typical Low $17.38 Median $57.54 Typical High $63.10 | Professional | None | $17.38 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | None | $50.12 | $50.12 | $52.48 |
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 $35.48 Median $37.15 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $35.48 | $37.15 | $37.15 |
Where Idaho sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 35th of 51
$50.12
AK $72.44HI $10.96
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.