How much rates vary
Facilitymedian $65 · 10th to 90th $18 to $525Professionalmedian $36 · 10th to 90th $16 to $68
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 $19.50 Median $24.55 Typical High $75.86 | Facility | None | $19.50 | $24.55 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $34.67 Typical High $54.95 | Professional | None | $12.30 | $34.67 | $54.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $10.96 Median $141.25 Typical High $467.74 | Facility | None | $10.96 | $141.25 | $467.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $16.98 Median $46.77 Typical High $77.62 | Professional | None | $16.98 | $46.77 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $41.69 Typical High $63.10 | Professional | None | $15.85 | $41.69 | $63.10 |
Hally Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $281.84 | Professional | None | $29.51 | $29.51 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $19.50 Median $107.15 Typical High $575.44 | Facility | None | $19.50 | $107.15 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $40.74 Typical High $74.13 | Professional | None | $15.49 | $40.74 | $74.13 |
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 $17.78 Median $17.78 Typical High $64.57 | Facility | None | $17.78 | $17.78 | $64.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $64.57 | Professional | None | $17.38 | $18.62 | $64.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $61.66 | Professional | None | $16.98 | $29.51 | $61.66 |
Select Health Setting Facility Modifier None Typical Low $10.96 Median $33.88 Typical High $34.67 | Facility | None | $10.96 | $33.88 | $34.67 |
Select Health Setting Professional Modifier None Typical Low $16.22 Median $33.88 Typical High $52.48 | Professional | None | $16.22 | $33.88 | $52.48 |
United Setting Professional Modifier None Typical Low $12.88 Median $38.02 Typical High $67.61 | Professional | None | $12.88 | $38.02 | $67.61 |
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 $8.13 Median $15.14 Typical High $25.12 | Professional | 52 · Reduced service | $8.13 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $6.03 Typical High $10.23 | Professional | 53 · Discontinued | $3.24 | $6.03 | $10.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.88 Median $15.85 Typical High $56.23 | Professional | 78 · Unplanned return to OR | $12.88 | $15.85 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $10.00 Typical High $25.12 | Professional | 52 · Reduced service | $8.13 | $10.00 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.98 Typical High $10.23 | Professional | 53 · Discontinued | $3.24 | $3.98 | $10.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $12.59 Typical High $39.81 | Professional | 54 · Surgery only | $12.59 | $12.59 | $39.81 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $5.75 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $5.75 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $13.49 Median $13.49 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $13.49 | $13.49 | $42.66 |
Where Idaho sits
The same service costs 2.5 times more in Kansas than in Maryland. 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· 16th of 51
$39.81
KS $54.95MD $22.39
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.