How much rates vary
Facilitymedian $87 · 10th to 90th $76 to $145Professionalmedian $79 · 10th to 90th $35 to $3,388
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 $79.43 Typical High $79.43 | Professional | None | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $13.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $7.94 |
BCBS Idaho Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $144.54 | Facility | None | $70.79 | $87.10 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $74.13 Median $79.43 Typical High $112.20 | Facility | None | $74.13 | $79.43 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $95.50 | Professional | None | $74.13 | $79.43 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $37.15 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.79 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $10.96 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $7.94 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $5,495.41 | Facility | None | $114.82 | $114.82 | $5,495.41 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $22.91 Median $114.82 Typical High $6,456.54 | Professional | None | $22.91 | $114.82 | $6,456.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $131.83 | Facility | None | $85.11 | $87.10 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $117.49 | Facility | None | $85.11 | $91.20 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $181.97 | Professional | None | $83.18 | $91.20 | $181.97 |
United Setting Professional Modifier None Typical Low $15.14 Median $35.48 Typical High $38.02 | Professional | None | $15.14 | $35.48 | $38.02 |
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 $67.61 Median $67.61 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $67.61 | $67.61 | $70.79 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii than in Utah. 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· 5th of 51
$79.43
HI $102UT $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.