How much rates vary
Facilitymedian $11 · 10th to 90th $7 to $19Professionalmedian $12 · 10th to 90th $5 to $15
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 Typical Low $6.46 Median $15.49 Typical High $15.49 | Professional | None | $6.46 | $15.49 | $15.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.24 Median $10.96 Typical High $18.62 | Facility | None | $7.24 | $10.96 | $18.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $8.32 Median $12.30 Typical High $12.88 | Professional | None | $8.32 | $12.30 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $3.16 Median $11.22 Typical High $15.49 | Facility | None | $3.16 | $11.22 | $15.49 |
Moda Health Setting Professional Modifier None Typical Low $8.51 Median $12.30 Typical High $15.49 | Professional | None | $8.51 | $12.30 | $15.49 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $30.20 | Professional | None | $8.13 | $12.30 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $9.33 Median $14.79 Typical High $707.95 | Facility | None | $9.33 | $14.79 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $831.76 | Professional | None | $11.75 | $14.79 | $831.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $12.30 | Professional | None | $8.32 | $8.32 | $12.30 |
Select Health Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $15.14 | Facility | None | $11.75 | $11.75 | $15.14 |
Select Health Setting Professional Modifier None Typical Low $7.59 Median $11.75 Typical High $12.88 | Professional | None | $7.59 | $11.75 | $12.88 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $7.59 | Professional | None | $4.47 | $4.90 | $7.59 |
9 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 $3.24 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $3.24 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $1.32 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $0.98 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $0.65 | $1.55 | $1.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $7.76 Median $8.71 Typical High $9.12 | Professional | 78 · Unplanned return to OR | $7.76 | $8.71 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.24 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $3.24 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $1.32 | $3.16 | $3.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $0.98 | $2.34 | $2.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $0.65 | $1.55 | $1.55 |
Where Idaho sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 1st of 51
$12.30
ID $12.30CT $5.75
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.