How much rates vary
Facilitymedian $148 · 10th to 90th $21 to $195Professionalmedian $126 · 10th to 90th $68 to $200
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 $79.43 Median $89.13 Typical High $89.13 | Professional | None | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $39.81 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.85 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $8.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.22 Median $20.89 Typical High $57.54 | Facility | None | $16.22 | $20.89 | $57.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $23.44 Median $67.61 Typical High $151.36 | Professional | None | $23.44 | $67.61 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $213.80 | Facility | None | $144.54 | $158.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $128.82 | Facility | None | $70.79 | $89.13 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $223.87 | Professional | None | $79.43 | $89.13 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $39.81 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.85 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $8.91 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Facility | None | $147.91 | $147.91 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $213.80 | Professional | None | $125.89 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
5 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.22 Median $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $16.22 | $177.83 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 22 · Increased work | $25.70 | $25.70 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 54 · Surgery only | $16.22 | $16.22 | $16.22 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 63 · Small infant | $25.70 | $25.70 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 78 · Unplanned return to OR | $17.38 | $17.38 | $17.38 |
Where Idaho sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 11th of 51
$126
ND $141MD $70.79
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.