How much rates vary
Facilitymedian $126 · 10th to 90th $112 to $209Professionalmedian $112 · 10th to 90th $43 to $4,898
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 $104.71 Median $112.20 Typical High $112.20 | Professional | None | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $52.48 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $20.89 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $11.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $208.93 | Facility | None | $109.65 | $125.89 | $208.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $162.18 | Facility | None | $104.71 | $112.20 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | None | $97.72 | $112.20 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $52.48 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $20.89 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $11.22 |
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 $165.96 Median $165.96 Typical High $7,943.28 | Facility | None | $165.96 | $165.96 | $7,943.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $9,332.54 | Professional | None | $33.11 | $165.96 | $9,332.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $190.55 | Facility | None | $123.03 | $125.89 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $169.82 | Facility | None | $131.83 | $131.83 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $257.04 | Professional | None | $128.82 | $131.83 | $257.04 |
United Setting Professional Modifier None Typical Low $15.14 Median $58.88 Typical High $64.57 | Professional | None | $15.14 | $58.88 | $64.57 |
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 $95.50 Median $97.72 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $95.50 | $97.72 | $102.33 |
Where Idaho sits
The same service costs 2.9 times more in Hawaii than in New York. 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
$112
HI $170NY $58.88
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.