How much rates vary
Facilitymedian $115 · 10th to 90th $63 to $200Professionalmedian $98 · 10th to 90th $66 to $126
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $74.13 Median $91.20 Typical High $100.00 | Professional | None (both parts) | $74.13 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 26 · Professional part | $23.99 | $31.62 | $31.62 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $60.26 Typical High $70.79 | Professional | TC · Technical part | $51.29 | $60.26 | $70.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $138.04 Typical High $199.53 | Facility | None | $97.72 | $138.04 | $199.53 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $97.72 Median $102.33 Typical High $141.25 | Professional | None (both parts) | $97.72 | $102.33 | $141.25 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $34.67 Typical High $47.86 | Professional | 26 · Professional part | $31.62 | $34.67 | $47.86 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | TC · Technical part | $66.07 | $66.07 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $93.33 Typical High $112.20 | Professional | None (both parts) | $66.07 | $93.33 | $112.20 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $22.39 Median $30.90 Typical High $38.02 | Professional | 26 · Professional part | $22.39 | $30.90 | $38.02 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $63.10 Typical High $74.13 | Professional | TC · Technical part | $43.65 | $63.10 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $131.83 | Facility | None | $91.20 | $91.20 | $131.83 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $74.13 Median $91.20 Typical High $125.89 | Professional | None (both parts) | $74.13 | $91.20 | $125.89 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $31.62 Typical High $37.15 | Professional | 26 · Professional part | $23.99 | $31.62 | $37.15 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $60.26 Typical High $70.79 | Professional | TC · Technical part | $56.23 | $60.26 | $70.79 |
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 $95.50 Median $112.20 Typical High $112.20 | Facility | None | $95.50 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $15.49 Median $112.20 Typical High $114.82 | Professional | None (both parts) | $15.49 | $112.20 | $114.82 |
MountainHealth Co-op Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 26 · Professional part | $25.70 | $25.70 | $25.70 |
MountainHealth Co-op Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | TC · Technical part | $51.29 | $51.29 | $51.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $199.53 | Facility | None | $107.15 | $154.88 | $199.53 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | None (both parts) | $97.72 | $97.72 | $125.89 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | 26 · Professional part | $31.62 | $31.62 | $38.90 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | TC · Technical part | $66.07 | $66.07 | $87.10 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
Select Health Setting Professional Modifier None (both parts) Typical Low $61.66 Median $66.07 Typical High $123.03 | Professional | None (both parts) | $61.66 | $66.07 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $74.13 Median $102.33 Typical High $138.04 | Professional | None (both parts) | $74.13 | $102.33 | $138.04 |
United Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $31.62 Typical High $42.66 | Professional | 26 · Professional part | $23.44 | $31.62 | $42.66 |
United Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $70.79 Typical High $95.50 | Professional | TC · Technical part | $52.48 | $70.79 | $95.50 |
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 $42.66 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $42.66 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $16.98 | $18.20 | $19.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $93.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $70.79 | $93.33 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $45.71 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.95 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 22 · Increased work | $112.20 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $70.79 | $70.79 | $70.79 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 63 · Small infant | $112.20 | $112.20 | $112.20 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $75.86 |
Where Idaho sits
The same service costs 4.9 times more in Nebraska 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· 13th of 51
$97.72
NE $155UT $31.62
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.