How much rates vary
Facilitymedian $52 · 10th to 90th $45 to $89Professionalmedian $45 · 10th to 90th $19 to $1,905
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 $35.48 Median $44.67 Typical High $44.67 | Professional | None | $35.48 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $17.78 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.08 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.37 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.55 | $4.47 | $4.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $42.66 Median $50.12 Typical High $83.18 | Facility | None | $42.66 | $50.12 | $83.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $41.69 Median $44.67 Typical High $64.57 | Facility | None | $41.69 | $44.67 | $64.57 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $54.95 | Professional | None | $41.69 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $20.89 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.32 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $6.31 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $4.47 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | None | $10.23 | $10.23 | $12.02 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $3,090.30 | Facility | None | $64.57 | $64.57 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.88 Median $64.57 Typical High $3,630.78 | Professional | None | $12.88 | $64.57 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $48.98 Median $50.12 Typical High $74.13 | Facility | None | $48.98 | $50.12 | $74.13 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $66.07 | Facility | None | $51.29 | $52.48 | $66.07 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $102.33 | Professional | None | $50.12 | $52.48 | $102.33 |
United Setting Professional Modifier None Typical Low $10.96 Median $18.62 Typical High $20.42 | Professional | None | $10.96 | $18.62 | $20.42 |
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 $38.02 Median $38.02 Typical High $39.81 | Professional | 78 · Unplanned return to OR | $38.02 | $38.02 | $39.81 |
Where Idaho sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 5th of 51
$44.67
MT $64.57IN $19.95
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.