How much rates vary
Facilitymedian $71 · 10th to 90th $62 to $112Professionalmedian $62 · 10th to 90th $29 to $2,630
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 $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.51 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $112.20 | Facility | None | $56.23 | $67.61 | $112.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $87.10 | Facility | None | $57.54 | $61.66 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $74.13 | Professional | None | $52.48 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $28.18 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.51 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | None | $6.76 | $6.76 | $7.94 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $4,265.80 | Facility | None | $89.13 | $89.13 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $17.78 Median $89.13 Typical High $5,011.87 | Professional | None | $17.78 | $89.13 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $102.33 | Facility | None | $66.07 | $67.61 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | None | $70.79 | $70.79 | $95.50 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $141.25 | Professional | None | $69.18 | $77.62 | $141.25 |
United Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $34.67 | Professional | None | $10.96 | $32.36 | $34.67 |
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 $52.48 Median $52.48 Typical High $54.95 | Professional | 78 · Unplanned return to OR | $52.48 | $52.48 | $54.95 |
Where Idaho sits
The same service costs 3.1 times more in Montana than in New York. 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· 15th of 51
$61.66
MT $100NY $32.36
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.