How much rates vary
Facilitymedian $56 · 10th to 90th $48 to $89Professionalmedian $48 · 10th to 90th $24 to $2,089
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 $44.67 Median $47.86 Typical High $47.86 | Professional | None | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $8.91 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.47 | $4.79 | $4.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $46.77 Median $53.70 Typical High $89.13 | Facility | None | $46.77 | $53.70 | $89.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $47.86 Typical High $69.18 | Facility | None | $44.67 | $47.86 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | None | $44.67 | $47.86 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $22.39 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $8.91 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.47 | $4.79 | $4.79 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $3,388.44 | Facility | None | $70.79 | $70.79 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $14.13 Median $70.79 Typical High $3,981.07 | Professional | None | $14.13 | $70.79 | $3,981.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $81.28 | Facility | None | $52.48 | $53.70 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Facility | None | $56.23 | $56.23 | $72.44 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $109.65 | Professional | None | $54.95 | $56.23 | $109.65 |
United Setting Professional Modifier None Typical Low $10.96 Median $23.99 Typical High $25.70 | Professional | None | $10.96 | $23.99 | $25.70 |
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 $40.74 Median $41.69 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $40.74 | $41.69 | $43.65 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii 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· 12th of 51
$47.86
HI $75.86MO $25.70
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.