How much rates vary
Facilitymedian $129 · 10th to 90th $112 to $204Professionalmedian $112 · 10th to 90th $50 to $4,786
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 $91.20 Median $112.20 Typical High $112.20 | Professional | None | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $11.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $204.17 | Facility | None | $107.15 | $123.03 | $204.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $158.49 | Facility | None | $104.71 | $112.20 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $134.90 | Professional | None | $104.71 | $112.20 | $134.90 |
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 $15.49 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $16.60 |
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 $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $7,762.47 | Facility | None | $162.18 | $162.18 | $7,762.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $32.36 Median $162.18 Typical High $9,120.11 | Professional | None | $32.36 | $162.18 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $186.21 | Facility | None | $120.23 | $123.03 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $165.96 | Facility | None | $128.82 | $128.82 | $165.96 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $257.04 | Professional | None | $125.89 | $128.82 | $257.04 |
United Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $53.70 | Professional | None | $41.69 | $51.29 | $53.70 |
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 $95.50 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $100.00 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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· 8th of 51
$112
HI $166AZ $52.48
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.