How much rates vary
Facilitymedian $269 · 10th to 90th $11 to $513Professionalmedian $11 · 10th to 90th $2 to $14
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | None | $10.00 | $10.96 | $10.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $501.19 | Facility | None | $204.17 | $309.03 | $501.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $12.88 | Professional | None | $7.59 | $7.59 | $12.88 |
Moda Health Setting Facility Modifier None Typical Low $10.00 Median $10.96 Typical High $5,495.41 | Facility | None | $10.00 | $10.96 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $8.91 Median $10.96 Typical High $14.13 | Professional | None | $8.91 | $10.96 | $14.13 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $14.45 | Facility | None | $12.02 | $12.02 | $14.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.62 Median $11.75 Typical High $14.45 | Professional | None | $1.62 | $11.75 | $14.45 |
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 Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | None | $11.48 | $11.48 | $13.18 |
Select Health Setting Facility Modifier None Typical Low $7.59 Median $7.76 Typical High $263.03 | Facility | None | $7.59 | $7.76 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $15.14 | Professional | None | $7.08 | $10.00 | $15.14 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.02 Typical High $16.22 | Professional | None | $8.71 | $12.02 | $16.22 |
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 $5.01 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.01 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.00 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $8.13 Typical High $8.13 | Professional | 54 · Surgery only | $7.59 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.51 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.01 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.00 | $2.19 | $2.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $8.13 Typical High $8.13 | Professional | 54 · Surgery only | $7.59 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.51 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.10 |
Where Idaho sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$11.48
HI $18.20NC $7.76
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.