How much rates vary
Facilitymedian $316 · 10th to 90th $79 to $2,455Professionalmedian $138 · 10th to 90th $93 to $219
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 Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | None | $83.18 | $120.23 | $158.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $85.11 Median $354.81 Typical High $2,454.71 | Facility | None | $85.11 | $354.81 | $2,454.71 |
BCBS Idaho Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $257.04 | Professional | None | $93.33 | $151.36 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $107.15 | Facility | None | $70.79 | $79.43 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $181.97 | Professional | None | $107.15 | $138.04 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $229.09 Typical High $4,466.84 | Facility | None | $95.50 | $229.09 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $239.88 | Professional | None | $87.10 | $138.04 | $239.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Facility | None | $125.89 | $125.89 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,630.27 | Facility | None | $1,230.27 | $1,819.70 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $204.17 | Professional | None | $93.33 | $138.04 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $645.65 | Facility | None | $107.15 | $109.65 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $144.54 | Professional | None | $89.13 | $107.15 | $144.54 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $199.53 | Professional | None | $89.13 | $134.90 | $199.53 |
8 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 $43.65 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $43.65 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $17.38 | $21.88 | $31.62 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $117.49 | $158.49 | $234.42 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $25.70 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $25.70 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $154.88 Median $190.55 Typical High $269.15 | Professional | 63 · Small infant | $154.88 | $190.55 | $269.15 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $107.15 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $83.18 | $107.15 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $43.65 | $53.70 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $17.38 | $21.88 | $31.62 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 20th of 51
$138
AK $263KY $93.33
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.