How much rates vary
Facilitymedian $35 · 10th to 90th $30 to $81Professionalmedian $30 · 10th to 90th $16 to $1,288
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 $28.18 Median $30.20 Typical High $30.20 | Professional | None | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.13 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.62 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.17 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.82 | $3.02 | $3.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $27.54 Median $33.11 Typical High $54.95 | Facility | None | $27.54 | $33.11 | $54.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $30.20 Typical High $42.66 | Facility | None | $28.18 | $30.20 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $36.31 | Professional | None | $28.18 | $30.20 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.13 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.62 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.17 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.82 | $3.02 | $3.02 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | None | $16.98 | $19.95 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $2,089.30 | Facility | None | $43.65 | $43.65 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.71 Median $43.65 Typical High $2,454.71 | Professional | None | $8.71 | $43.65 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $32.36 Median $33.11 Typical High $50.12 | Facility | None | $32.36 | $33.11 | $50.12 |
Select Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $44.67 | Facility | None | $34.67 | $34.67 | $44.67 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $69.18 | Professional | None | $30.90 | $34.67 | $69.18 |
United Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $16.98 | Professional | None | $13.49 | $16.22 | $16.98 |
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 $25.70 Median $25.70 Typical High $26.92 | Professional | 78 · Unplanned return to OR | $25.70 | $25.70 | $26.92 |
Where Idaho sits
The same service costs 5.9 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· 14th of 51
$30.20
HI $97.72UT $16.60
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.