How much rates vary
Facilitymedian $141 · 10th to 90th $16 to $417Professionalmedian $28 · 10th to 90th $12 to $62
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 $9.55 Median $28.18 Typical High $91.20 | Professional | None | $9.55 | $28.18 | $91.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $204.17 | Facility | None | $93.33 | $112.20 | $204.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $18.20 Median $19.05 Typical High $61.66 | Professional | None | $18.20 | $19.05 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $46.77 | Professional | None | $12.88 | $30.20 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $11.48 Median $40.74 Typical High $346.74 | Facility | None | $11.48 | $40.74 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $28.18 Typical High $91.20 | Professional | None | $12.02 | $28.18 | $91.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $77.62 | Professional | None | $30.20 | $30.20 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $60.26 | Facility | None | $15.85 | $15.85 | $60.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $15.85 Median $16.98 Typical High $61.66 | Professional | None | $15.85 | $16.98 | $61.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $61.66 | Professional | None | $17.78 | $19.05 | $61.66 |
Select Health Setting Facility Modifier None Typical Low $28.84 Median $29.51 Typical High $67.61 | Facility | None | $28.84 | $29.51 | $67.61 |
Select Health Setting Professional Modifier None Typical Low $10.00 Median $28.84 Typical High $38.90 | Professional | None | $10.00 | $28.84 | $38.90 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $10.00 Median $22.91 Typical High $50.12 | Professional | None | $10.00 | $22.91 | $50.12 |
10 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $14.13 Typical High $45.71 | Professional | 52 · Reduced service | $5.75 | $14.13 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $5.62 Typical High $18.20 | Professional | 53 · Discontinued | $2.29 | $5.62 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $20.89 Typical High $67.61 | Professional | 54 · Surgery only | $8.51 | $20.89 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $4.17 Typical High $13.49 | Professional | 55 · Aftercare only | $1.74 | $4.17 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $2.82 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.12 | $2.82 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $14.13 Typical High $45.71 | Professional | 52 · Reduced service | $6.03 | $14.13 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $5.62 Typical High $18.20 | Professional | 53 · Discontinued | $2.45 | $5.62 | $18.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $20.89 Typical High $67.61 | Professional | 54 · Surgery only | $9.12 | $20.89 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $4.17 Typical High $13.49 | Professional | 55 · Aftercare only | $1.82 | $4.17 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $2.82 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.23 | $2.82 | $9.12 |
Where Idaho sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 21st of 51
$32.36
WI $67.61NE $16.22
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.