How much rates vary
Facilitymedian $54 · 10th to 90th $46 to $87Professionalmedian $46 · 10th to 90th $21 to $1,995
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 $38.90 Median $45.71 Typical High $45.71 | Professional | None | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $7.76 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.89 | $4.57 | $4.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $42.66 Median $51.29 Typical High $85.11 | Facility | None | $42.66 | $51.29 | $85.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $66.07 | Facility | None | $42.66 | $45.71 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $56.23 | Professional | None | $42.66 | $45.71 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $21.38 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $8.51 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $4.57 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $3,235.94 | Facility | None | $67.61 | $67.61 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.49 Median $67.61 Typical High $3,801.89 | Professional | None | $13.49 | $67.61 | $3,801.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $77.62 | Facility | None | $50.12 | $51.29 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $69.18 | Facility | None | $53.70 | $53.70 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $104.71 | Professional | None | $51.29 | $53.70 | $104.71 |
United Setting Professional Modifier None Typical Low $10.96 Median $20.89 Typical High $22.39 | Professional | None | $10.96 | $20.89 | $22.39 |
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 $38.90 Median $39.81 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $38.90 | $39.81 | $41.69 |
Where Idaho sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 7th of 51
$45.71
MT $74.13MO $22.39
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.