How much rates vary
Facilitymedian $91 · 10th to 90th $81 to $151Professionalmedian $83 · 10th to 90th $28 to $3,548
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 $74.13 Median $83.18 Typical High $83.18 | Professional | None | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $14.79 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $10.96 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.41 | $8.32 | $8.32 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $151.36 | Facility | None | $75.86 | $91.20 | $151.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $83.18 Typical High $117.49 | Facility | None | $77.62 | $83.18 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $100.00 | Professional | None | $75.86 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.32 |
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 $120.23 Median $120.23 Typical High $5,754.40 | Facility | None | $120.23 | $120.23 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $23.99 Median $120.23 Typical High $6,760.83 | Professional | None | $23.99 | $120.23 | $6,760.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $138.04 | Facility | None | $89.13 | $91.20 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $95.50 Typical High $123.03 | Facility | None | $91.20 | $95.50 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $190.55 | Professional | None | $89.13 | $95.50 | $190.55 |
United Setting Professional Modifier None Typical Low $12.88 Median $39.81 Typical High $42.66 | Professional | None | $12.88 | $39.81 | $42.66 |
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 $70.79 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $74.13 |
Where Idaho sits
The same service costs 2.4 times more in Hawaii 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· 8th of 51
$83.18
HI $100OH $41.69
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.