How much rates vary
Facilitymedian $380 · 10th to 90th $200 to $794Professionalmedian $186 · 10th to 90th $123 to $240
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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | None (both parts) | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 26 · Professional part | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | TC · Technical part | $109.65 | $109.65 | $147.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $251.19 Median $478.63 Typical High $831.76 | Facility | None | $251.19 | $478.63 | $831.76 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $288.40 | Professional | None (both parts) | $186.21 | $186.21 | $288.40 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | 26 · Professional part | $53.70 | $53.70 | $81.28 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | TC · Technical part | $131.83 | $131.83 | $204.17 |
Cigna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $208.93 | Professional | None (both parts) | $123.03 | $123.03 | $208.93 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $36.31 Typical High $61.66 | Professional | 26 · Professional part | $36.31 | $36.31 | $61.66 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | TC · Technical part | $87.10 | $87.10 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $3,981.07 | Facility | None | $162.18 | $199.53 | $3,981.07 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $151.36 Median $199.53 Typical High $239.88 | Professional | None (both parts) | $151.36 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $51.29 Typical High $66.07 | Professional | 26 · Professional part | $41.69 | $51.29 | $66.07 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $109.65 Median $109.65 Typical High $173.78 | Professional | TC · Technical part | $109.65 | $109.65 | $173.78 |
Molina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None (both parts) | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $213.80 Median $239.88 Typical High $239.88 | Facility | None | $213.80 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $31.62 Median $229.09 Typical High $239.88 | Professional | None (both parts) | $31.62 | $229.09 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 26 · Professional part | $44.67 | $44.67 | $44.67 |
MountainHealth Co-op Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | TC · Technical part | $112.20 | $112.20 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $512.86 | Facility | None | $269.15 | $407.38 | $512.86 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None (both parts) | $186.21 | $186.21 | $199.53 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 26 · Professional part | $53.70 | $53.70 | $63.10 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | TC · Technical part | $131.83 | $131.83 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $281.84 | Facility | None | $125.89 | $128.82 | $281.84 |
Select Health Setting Professional Modifier None (both parts) Typical Low $125.89 Median $186.21 Typical High $269.15 | Professional | None (both parts) | $125.89 | $186.21 | $269.15 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $218.78 Typical High $316.23 | Professional | None (both parts) | $151.36 | $218.78 | $316.23 |
United Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $52.48 Typical High $67.61 | Professional | 26 · Professional part | $38.90 | $52.48 | $67.61 |
United Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $165.96 Typical High $245.47 | Professional | TC · Technical part | $112.20 | $165.96 | $245.47 |
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 $79.43 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $79.43 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $19.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $79.43 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $32.36 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $19.95 |
Where Idaho sits
The same service costs 3.2 times more in Kansas 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· 22nd of 51
$186
KS $324UT $100
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.