How much rates vary
Facilitymedian $78 · 10th to 90th $66 to $123Professionalmedian $68 · 10th to 90th $28 to $2,884
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 $51.29 Median $67.61 Typical High $67.61 | Professional | None | $51.29 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $26.30 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $6.76 | $6.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $74.13 Typical High $123.03 | Facility | None | $61.66 | $74.13 | $123.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $95.50 | Facility | None | $63.10 | $67.61 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $81.28 | Professional | None | $63.10 | $67.61 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.30 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $6.76 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | None | $9.33 | $9.33 | $10.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $4,677.35 | Facility | None | $97.72 | $97.72 | $4,677.35 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $19.50 Median $97.72 Typical High $5,495.41 | Professional | None | $19.50 | $97.72 | $5,495.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $112.20 | Facility | None | $72.44 | $74.13 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $77.62 Typical High $100.00 | Facility | None | $72.44 | $77.62 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $154.88 | Professional | None | $66.07 | $77.62 | $154.88 |
United Setting Professional Modifier None Typical Low $12.88 Median $28.18 Typical High $30.90 | Professional | None | $12.88 | $28.18 | $30.90 |
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 $57.54 Median $57.54 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $60.26 |
Where Idaho sits
The same service costs 2.8 times more in Montana than in Ohio. 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· 3rd of 51
$67.61
MT $83.18OH $30.20
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.