How much rates vary
Facilitymedian $15 · 10th to 90th $13 to $76Professionalmedian $13 · 10th to 90th $5 to $550
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 $10.72 Median $12.88 Typical High $12.88 | Professional | None | $10.72 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.14 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.62 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.07 | $1.29 | $1.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $12.30 Median $14.45 Typical High $23.99 | Facility | None | $12.30 | $14.45 | $23.99 |
BCBS Idaho Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $12.88 Typical High $18.62 | Facility | None | $12.02 | $12.88 | $18.62 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $15.85 | Professional | None | $12.02 | $12.88 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.62 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.24 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.70 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.12 | $1.29 | $1.29 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $10.00 Typical High $30.20 | Professional | None | $8.51 | $10.00 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $912.01 | Facility | None | $18.62 | $18.62 | $912.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.80 Median $18.62 Typical High $1,047.13 | Professional | None | $3.80 | $18.62 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $14.13 Median $14.45 Typical High $21.38 | Facility | None | $14.13 | $14.45 | $21.38 |
Select Health Setting Facility Modifier None Typical Low $13.80 Median $15.14 Typical High $19.50 | Facility | None | $13.80 | $15.14 | $19.50 |
Select Health Setting Professional Modifier None Typical Low $12.59 Median $15.14 Typical High $29.51 | Professional | None | $12.59 | $15.14 | $29.51 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.75 Typical High $6.17 | Professional | None | $4.07 | $5.75 | $6.17 |
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 $10.96 Median $10.96 Typical High $11.48 | Professional | 78 · Unplanned return to OR | $10.96 | $10.96 | $11.48 |
Where Idaho sits
The same service costs 2.7 times more in Montana 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· 5th of 51
$12.88
MT $16.22UT $6.03
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.