How much rates vary
Facilitymedian $60 · 10th to 90th $51 to $95Professionalmedian $51 · 10th to 90th $26 to $2,188
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 $47.86 Median $51.29 Typical High $51.29 | Professional | None | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $23.99 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $9.55 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $5.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $57.54 Typical High $95.50 | Facility | None | $48.98 | $57.54 | $95.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $74.13 | Facility | None | $47.86 | $51.29 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $63.10 | Professional | None | $47.86 | $51.29 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $23.99 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $9.55 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $5.13 |
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 $74.13 Median $74.13 Typical High $3,630.78 | Facility | None | $74.13 | $74.13 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $15.14 Median $74.13 Typical High $4,168.69 | Professional | None | $15.14 | $74.13 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $85.11 | Facility | None | $56.23 | $57.54 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Facility | None | $60.26 | $60.26 | $77.62 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $117.49 | Professional | None | $58.88 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $10.96 Median $26.92 Typical High $29.51 | Professional | None | $10.96 | $26.92 | $29.51 |
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 $43.65 Median $43.65 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $43.65 | $43.65 | $45.71 |
Where Idaho sits
The same service costs 2.6 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· 16th of 51
$51.29
MT $74.13IN $28.84
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.