How much rates vary
Facilitymedian $355 · 10th to 90th $214 to $603Professionalmedian $324 · 10th to 90th $158 to $468
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 $245.47 Median $323.59 Typical High $323.59 | Professional | None | $245.47 | $323.59 | $323.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $602.56 | Facility | None | $288.40 | $354.81 | $602.56 |
BCBS Idaho Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $407.38 | Professional | None | $263.03 | $389.05 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Facility | None | $218.78 | $218.78 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $323.59 Typical High $371.54 | Facility | None | $109.65 | $323.59 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $389.05 | Professional | None | $245.47 | $338.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $281.84 Typical High $323.59 | Professional | None | $30.20 | $281.84 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $467.74 Typical High $22,387.21 | Facility | None | $269.15 | $467.74 | $22,387.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $26,302.68 | Professional | None | $389.05 | $467.74 | $26,302.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $354.81 Typical High $537.03 | Facility | None | $346.74 | $354.81 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $389.05 | Professional | None | $263.03 | $263.03 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $371.54 Typical High $478.63 | Facility | None | $346.74 | $371.54 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $407.38 | Professional | None | $239.88 | $371.54 | $407.38 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $169.82 | Facility | None | $36.31 | $36.31 | $169.82 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $251.19 | Professional | None | $151.36 | $169.82 | $251.19 |
9 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $32.36 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $32.36 |
Where Idaho sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 12th of 51
$324
GA $372AK $102
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.