How much rates vary
Facilitymedian $269 · 10th to 90th $91 to $513Professionalmedian $120 · 10th to 90th $56 to $204
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 (both parts) Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $25.12 Typical High $25.12 | Professional | 26 · Professional part | $19.95 | $25.12 | $25.12 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $60.26 Typical High $61.66 | Professional | TC · Technical part | $47.86 | $60.26 | $61.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $91.20 Median $269.15 Typical High $512.86 | Facility | None | $91.20 | $269.15 | $512.86 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $120.23 Median $123.03 Typical High $239.88 | Professional | None (both parts) | $120.23 | $123.03 | $239.88 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $30.90 Typical High $48.98 | Professional | 26 · Professional part | $28.18 | $30.90 | $48.98 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $93.33 Typical High $190.55 | Professional | TC · Technical part | $91.20 | $93.33 | $190.55 |
Cigna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $83.18 Typical High $97.72 | Professional | None (both parts) | $56.23 | $83.18 | $97.72 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $24.55 Typical High $30.20 | Professional | 26 · Professional part | $17.78 | $24.55 | $30.20 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $57.54 Typical High $69.18 | Professional | TC · Technical part | $38.02 | $57.54 | $69.18 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $85.11 Typical High $120.23 | Facility | None | $47.86 | $85.11 | $120.23 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $83.18 Median $125.89 Typical High $199.53 | Professional | None (both parts) | $83.18 | $125.89 | $199.53 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $25.12 Typical High $39.81 | Professional | 26 · Professional part | $22.91 | $25.12 | $39.81 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $60.26 Median $61.66 Typical High $158.49 | Professional | TC · Technical part | $60.26 | $61.66 | $158.49 |
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 $158.49 Median $190.55 Typical High $190.55 | Facility | None | $158.49 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $26.30 Median $190.55 Typical High $190.55 | Professional | None (both parts) | $26.30 | $190.55 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 26 · Professional part | $26.92 | $26.92 | $26.92 |
MountainHealth Co-op Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | TC · Technical part | $104.71 | $104.71 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $741.31 | Facility | None | $295.12 | $478.63 | $741.31 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | None (both parts) | $114.82 | $120.23 | $134.90 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 26 · Professional part | $28.18 | $28.18 | $33.88 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $91.20 Typical High $102.33 | Professional | TC · Technical part | $89.13 | $91.20 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $354.81 | Facility | None | $104.71 | $107.15 | $354.81 |
Select Health Setting Professional Modifier None (both parts) Typical Low $87.10 Median $104.71 Typical High $154.88 | Professional | None (both parts) | $87.10 | $104.71 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $69.18 Median $91.20 Typical High $128.82 | Professional | None (both parts) | $69.18 | $91.20 | $128.82 |
United Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $25.70 Typical High $36.31 | Professional | 26 · Professional part | $20.42 | $25.70 | $36.31 |
United Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $64.57 Typical High $87.10 | Professional | TC · Technical part | $48.98 | $64.57 | $87.10 |
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 $41.69 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $87.10 | $158.49 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 22 · Increased work | $134.90 | $134.90 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $87.10 | $87.10 | $87.10 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 63 · Small infant | $134.90 | $134.90 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $93.33 |
Where Idaho sits
The same service costs 3.5 times more in North Dakota than in Kentucky. 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· 11th of 51
$120
ND $186KY $53.70
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.