How much rates vary
Facilitymedian $83 · 10th to 90th $74 to $138Professionalmedian $74 · 10th to 90th $36 to $3,236
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 $69.18 Median $74.13 Typical High $74.13 | Professional | None | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.80 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $7.41 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $138.04 | Facility | None | $67.61 | $83.18 | $138.04 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $74.13 Typical High $107.15 | Facility | None | $69.18 | $74.13 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | None | $69.18 | $74.13 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.80 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $7.41 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $30.20 | Professional | None | $21.38 | $25.12 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $5,248.07 | Facility | None | $109.65 | $109.65 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $21.88 Median $109.65 Typical High $6,165.95 | Professional | None | $21.88 | $109.65 | $6,165.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $125.89 | Facility | None | $81.28 | $83.18 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $112.20 | Facility | None | $87.10 | $87.10 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $173.78 | Professional | None | $79.43 | $87.10 | $173.78 |
United Setting Professional Modifier None Typical Low $19.05 Median $36.31 Typical High $38.90 | Professional | None | $19.05 | $36.31 | $38.90 |
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 $63.10 Median $64.57 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $63.10 | $64.57 | $67.61 |
Where Idaho sits
The same service costs 2.8 times more in Montana 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· 9th of 51
$74.13
MT $100NY $35.48
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.