How much rates vary
Facilitymedian $138 · 10th to 90th $123 to $229Professionalmedian $123 · 10th to 90th $55 to $5,248
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 $114.82 Median $123.03 Typical High $123.03 | Professional | None | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $12.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $229.09 | Facility | None | $117.49 | $138.04 | $229.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $123.03 Typical High $177.83 | Facility | None | $114.82 | $123.03 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | None | $114.82 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $57.54 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $12.30 |
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 $181.97 Median $181.97 Typical High $8,709.64 | Facility | None | $181.97 | $181.97 | $8,709.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $36.31 Median $181.97 Typical High $10,232.93 | Professional | None | $36.31 | $181.97 | $10,232.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $208.93 | Facility | None | $134.90 | $138.04 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $186.21 | Facility | None | $144.54 | $144.54 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $281.84 | Professional | None | $141.25 | $144.54 | $281.84 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $70.79 | Professional | None | $15.14 | $64.57 | $70.79 |
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 $104.71 Median $104.71 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $109.65 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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· 10th of 51
$123
HI $204IN $69.18
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.