How much rates vary
Facilitymedian $158 · 10th to 90th $76 to $209Professionalmedian $126 · 10th to 90th $69 to $204
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 $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $38.02 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.14 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $8.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.60 Median $48.98 Typical High $61.66 | Facility | None | $16.60 | $48.98 | $61.66 |
BCBS Idaho Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $151.36 | Professional | None | $51.29 | $51.29 | $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 $69.18 Median $85.11 Typical High $123.03 | Facility | None | $69.18 | $85.11 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $223.87 | Professional | None | $75.86 | $85.11 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $38.02 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.14 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $8.51 |
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 Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
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 |
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 $177.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $186.21 |
Where Idaho sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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
$126
ND $141NC $52.48
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.