How much rates vary
Facilitymedian $98 · 10th to 90th $85 to $155Professionalmedian $85 · 10th to 90th $32 to $3,631
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 $79.43 Median $85.11 Typical High $85.11 | Professional | None | $79.43 | $85.11 | $85.11 |
Aetna 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 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $154.88 | Facility | None | $77.62 | $93.33 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $120.23 | Facility | None | $79.43 | $85.11 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
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 $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
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 $123.03 Median $123.03 Typical High $5,888.44 | Facility | None | $123.03 | $123.03 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $123.03 Typical High $6,918.31 | Professional | None | $24.55 | $123.03 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $141.25 | Facility | None | $91.20 | $93.33 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Facility | None | $97.72 | $97.72 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $194.98 | Professional | None | $95.50 | $100.00 | $194.98 |
United Setting Professional Modifier None Typical Low $15.14 Median $44.67 Typical High $47.86 | Professional | None | $15.14 | $44.67 | $47.86 |
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 $72.44 Median $72.44 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $75.86 |
Where Idaho sits
The same service costs 2.5 times more in Montana than in Missouri. 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
$85.11
MT $115MO $46.77
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.