How much rates vary
Facilitymedian $81 · 10th to 90th $72 to $135Professionalmedian $72 · 10th to 90th $26 to $3,090
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 $67.61 Median $72.44 Typical High $72.44 | Professional | None | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.49 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $134.90 | Facility | None | $69.18 | $81.28 | $134.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $72.44 Typical High $104.71 | Facility | None | $67.61 | $72.44 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $89.13 | Professional | None | $67.61 | $72.44 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.49 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.24 |
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 $107.15 Median $107.15 Typical High $5,128.61 | Facility | None | $107.15 | $107.15 | $5,128.61 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $21.38 Median $107.15 Typical High $6,025.60 | Professional | None | $21.38 | $107.15 | $6,025.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $123.03 | Facility | None | $79.43 | $81.28 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $165.96 | Professional | None | $83.18 | $85.11 | $165.96 |
United Setting Professional Modifier None Typical Low $12.88 Median $35.48 Typical High $38.90 | Professional | None | $12.88 | $35.48 | $38.90 |
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 $61.66 Median $61.66 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $61.66 | $61.66 | $64.57 |
Where Idaho sits
The same service costs 2.6 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· 9th of 51
$72.44
MT $100OH $38.02
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.