How much rates vary
Facilitymedian $324 · 10th to 90th $110 to $603Professionalmedian $91 · 10th to 90th $36 to $120
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 Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $120.23 Typical High $120.23 | Professional | None | $42.66 | $120.23 | $120.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $257.04 Median $380.19 Typical High $660.69 | Facility | None | $257.04 | $380.19 | $660.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | None | $70.79 | $75.86 | $75.86 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $275.42 Typical High $363.08 | Facility | None | $120.23 | $275.42 | $363.08 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $120.23 Typical High $120.23 | Professional | None | $44.67 | $120.23 | $120.23 |
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 $100.00 Median $100.00 Typical High $141.25 | Facility | None | $100.00 | $100.00 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $128.82 | Professional | None | $100.00 | $100.00 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $478.63 | Facility | None | $109.65 | $151.36 | $478.63 |
United Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $85.11 | Professional | None | $36.31 | $56.23 | $85.11 |
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 $56.23 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $56.23 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $85.11 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $12.02 |
Where Idaho sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 7th of 51
$100
AK $141OH $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.