How much rates vary
Facilitymedian $224 · 10th to 90th $155 to $355Professionalmedian $170 · 10th to 90th $120 to $214
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 $165.96 Median $169.82 Typical High $169.82 | Professional | None | $165.96 | $169.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $158.49 Median $239.88 Typical High $354.81 | Facility | None | $158.49 | $239.88 | $354.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $186.21 | Professional | None | $144.54 | $151.36 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $204.17 | Professional | None | $120.23 | $141.25 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $245.47 | Facility | None | $134.90 | $169.82 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $213.80 | Professional | None | $165.96 | $173.78 | $213.80 |
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 $199.53 Median $218.78 Typical High $218.78 | Facility | None | $199.53 | $218.78 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $29.51 Median $213.80 Typical High $218.78 | Professional | None | $29.51 | $213.80 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $295.12 | Facility | None | $186.21 | $199.53 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | None | $186.21 | $186.21 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $489.78 | Facility | None | $117.49 | $117.49 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $229.09 | Professional | None | $117.49 | $128.82 | $229.09 |
United Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | None | $134.90 | $173.78 | $234.42 |
9 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 $83.18 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $16.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $165.96 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $83.18 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.11 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $16.98 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 12th of 51
$170
AK $269IN $95.50
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.