How much rates vary
Facilitymedian $62 · 10th to 90th $55 to $102Professionalmedian $56 · 10th to 90th $18 to $2,399
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 $46.77 Median $56.23 Typical High $56.23 | Professional | None | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $5.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $102.33 | Facility | None | $53.70 | $61.66 | $102.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $56.23 Typical High $79.43 | Facility | None | $52.48 | $56.23 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $67.61 | Professional | None | $52.48 | $56.23 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $25.70 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.47 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.76 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $5.62 |
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 $81.28 Median $81.28 Typical High $3,890.45 | Facility | None | $81.28 | $81.28 | $3,890.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.22 Median $81.28 Typical High $4,570.88 | Professional | None | $16.22 | $81.28 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $93.33 | Facility | None | $60.26 | $61.66 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $83.18 | Facility | None | $60.26 | $64.57 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $128.82 | Professional | None | $54.95 | $64.57 | $128.82 |
United Setting Professional Modifier None Typical Low $10.96 Median $25.12 Typical High $27.54 | Professional | None | $10.96 | $25.12 | $27.54 |
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 $47.86 Median $47.86 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $47.86 | $47.86 | $50.12 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$56.23
HI $69.18UT $26.92
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.