How much rates vary
Facilitymedian $66 · 10th to 90th $58 to $110Professionalmedian $59 · 10th to 90th $28 to $2,570
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 $54.95 Median $58.88 Typical High $58.88 | Professional | None | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $10.96 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $5.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $109.65 | Facility | None | $54.95 | $66.07 | $109.65 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $85.11 | Facility | None | $54.95 | $58.88 | $85.11 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $72.44 | Professional | None | $52.48 | $58.88 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $27.54 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $10.96 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $5.89 |
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 $87.10 Median $87.10 Typical High $4,168.69 | Facility | None | $87.10 | $87.10 | $4,168.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $17.38 Median $87.10 Typical High $4,897.79 | Professional | None | $17.38 | $87.10 | $4,897.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $100.00 | Facility | None | $64.57 | $66.07 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $69.18 Typical High $89.13 | Facility | None | $67.61 | $69.18 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $134.90 | Professional | None | $66.07 | $69.18 | $134.90 |
United Setting Professional Modifier None Typical Low $10.96 Median $30.90 Typical High $33.11 | Professional | None | $10.96 | $30.90 | $33.11 |
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 $50.12 Median $51.29 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $50.12 | $51.29 | $53.70 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii than in Alabama. 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· 14th of 51
$58.88
HI $87.10AL $32.36
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.