How much rates vary
Facilitymedian $93 · 10th to 90th $81 to $151Professionalmedian $81 · 10th to 90th $43 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 $75.86 Median $81.28 Typical High $81.28 | Professional | None | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.14 | $16.60 | $16.60 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $8.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $151.36 | Facility | None | $79.43 | $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 $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $81.28 Typical High $117.49 | Facility | None | $75.86 | $81.28 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $100.00 | Professional | None | $75.86 | $81.28 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $38.02 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.14 | $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 $7.59 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $8.13 |
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 $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 $95.50 Median $95.50 Typical High $123.03 | Facility | None | $95.50 | $95.50 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $190.55 | Professional | None | $93.33 | $95.50 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $42.66 Typical High $46.77 | Professional | None | $15.14 | $42.66 | $46.77 |
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 $69.18 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $69.18 | $70.79 | $74.13 |
Where Idaho sits
The same service costs 2.3 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· 16th of 51
$81.28
HI $107UT $45.71
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.