How much rates vary
Facilitymedian $102 · 10th to 90th $89 to $170Professionalmedian $91 · 10th to 90th $42 to $3,981
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 $83.18 Median $91.20 Typical High $91.20 | Professional | None | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $41.69 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $9.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $169.82 | Facility | None | $85.11 | $102.33 | $169.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $131.83 | Facility | None | $85.11 | $91.20 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $112.20 | Professional | None | $75.86 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $9.12 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | None | $42.66 | $42.66 | $50.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $6,456.54 | Facility | None | $134.90 | $134.90 | $6,456.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.92 Median $134.90 Typical High $7,585.78 | Professional | None | $26.92 | $134.90 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $154.88 | Facility | None | $100.00 | $102.33 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $138.04 | Facility | None | $107.15 | $107.15 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $208.93 | Professional | None | $104.71 | $107.15 | $208.93 |
United Setting Professional Modifier None Typical Low $12.88 Median $46.77 Typical High $50.12 | Professional | None | $12.88 | $46.77 | $50.12 |
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 $77.62 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $77.62 | $79.43 | $83.18 |
Where Idaho sits
The same service costs 2.6 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· 12th of 51
$91.20
HI $126OH $48.98
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.