How much rates vary
Facilitymedian $52 · 10th to 90th $47 to $87Professionalmedian $47 · 10th to 90th $18 to $2,042
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 $43.65 Median $46.77 Typical High $46.77 | Professional | None | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $21.88 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.37 | $4.68 | $4.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $87.10 | Facility | None | $45.71 | $52.48 | $87.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $67.61 | Facility | None | $43.65 | $46.77 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $57.54 | Professional | None | $43.65 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $21.88 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.71 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.37 | $4.68 | $4.68 |
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 $69.18 Median $69.18 Typical High $3,311.31 | Facility | None | $69.18 | $69.18 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.80 Median $69.18 Typical High $3,890.45 | Professional | None | $13.80 | $69.18 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $79.43 | Facility | None | $51.29 | $52.48 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Facility | None | $54.95 | $54.95 | $70.79 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $107.15 | Professional | None | $53.70 | $60.26 | $107.15 |
United Setting Professional Modifier None Typical Low $10.96 Median $24.55 Typical High $26.92 | Professional | None | $10.96 | $24.55 | $26.92 |
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 $39.81 Median $40.74 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $39.81 | $40.74 | $42.66 |
Where Idaho sits
The same service costs 3.3 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· 15th of 51
$46.77
MT $87.10IN $26.30
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.