How much rates vary
Facilitymedian $257 · 10th to 90th $41 to $490Professionalmedian $41 · 10th to 90th $27 to $59
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 $35.48 Median $41.69 Typical High $51.29 | Facility | None | $35.48 | $41.69 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | None (both parts) | $35.48 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $11.48 Typical High $12.88 | Professional | 26 · Professional part | $8.71 | $11.48 | $12.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $23.99 Typical High $30.90 | Professional | TC · Technical part | $23.99 | $23.99 | $30.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $416.87 | Facility | None | $144.54 | $257.04 | $416.87 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $40.74 Median $42.66 Typical High $63.10 | Professional | None (both parts) | $40.74 | $42.66 | $63.10 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $12.88 Typical High $18.20 | Professional | 26 · Professional part | $12.02 | $12.88 | $18.20 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $29.51 Typical High $44.67 | Professional | TC · Technical part | $28.84 | $29.51 | $44.67 |
Cigna Setting Professional Modifier None (both parts) Typical Low $26.92 Median $39.81 Typical High $45.71 | Professional | None (both parts) | $26.92 | $39.81 | $45.71 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $10.96 Typical High $13.49 | Professional | 26 · Professional part | $7.94 | $10.96 | $13.49 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $28.18 Typical High $32.36 | Professional | TC · Technical part | $18.62 | $28.18 | $32.36 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $269.15 Typical High $588.84 | Facility | None | $36.31 | $269.15 | $588.84 |
Moda Health Setting Facility Modifier TC · Technical part Typical Low $27.54 Median $269.15 Typical High $457.09 | Facility | TC · Technical part | $27.54 | $269.15 | $457.09 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $34.67 Median $40.74 Typical High $57.54 | Professional | None (both parts) | $34.67 | $40.74 | $57.54 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $11.48 Typical High $15.49 | Professional | 26 · Professional part | $8.71 | $11.48 | $15.49 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $25.70 Typical High $37.15 | Professional | TC · Technical part | $23.99 | $25.70 | $37.15 |
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 $41.69 Median $48.98 Typical High $48.98 | Facility | None | $41.69 | $48.98 | $48.98 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $6.92 Median $48.98 Typical High $50.12 | Professional | None (both parts) | $6.92 | $48.98 | $50.12 |
MountainHealth Co-op Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 26 · Professional part | $10.00 | $10.00 | $10.00 |
MountainHealth Co-op Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | TC · Technical part | $24.55 | $24.55 | $24.55 |
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 $40.74 Median $40.74 Typical High $43.65 | Professional | None (both parts) | $40.74 | $40.74 | $43.65 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $12.02 Typical High $13.80 | Professional | 26 · Professional part | $12.02 | $12.02 | $13.80 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | TC · Technical part | $28.84 | $28.84 | $30.20 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $28.18 Typical High $288.40 | Facility | None | $27.54 | $28.18 | $288.40 |
Select Health Setting Professional Modifier None (both parts) Typical Low $26.92 Median $27.54 Typical High $51.29 | Professional | None (both parts) | $26.92 | $27.54 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $32.36 Median $47.86 Typical High $64.57 | Professional | None (both parts) | $32.36 | $47.86 | $64.57 |
United Setting Professional Modifier 26 · Professional part Typical Low $8.51 Median $11.48 Typical High $15.49 | Professional | 26 · Professional part | $8.51 | $11.48 | $15.49 |
United Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $36.31 Typical High $48.98 | Professional | TC · Technical part | $24.55 | $36.31 | $48.98 |
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 $17.78 Median $17.78 Typical High $20.42 | Professional | 52 · Reduced service | $17.78 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.13 | Professional | 53 · Discontinued | $7.08 | $7.08 | $8.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $41.69 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $29.51 | $41.69 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $20.42 | Professional | 52 · Reduced service | $17.78 | $17.78 | $20.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.13 | Professional | 53 · Discontinued | $7.08 | $7.08 | $8.13 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 22 · Increased work | $46.77 | $46.77 | $46.77 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 54 · Surgery only | $29.51 | $29.51 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 63 · Small infant | $46.77 | $46.77 | $46.77 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 78 · Unplanned return to OR | $31.62 | $31.62 | $31.62 |
Where Idaho sits
The same service costs 2.5 times more in Minnesota than in Texas. 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· 14th of 51
$40.74
MN $67.61TX $26.92
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.