How much rates vary
Facilitymedian $11 · 10th to 90th $7 to $20Professionalmedian $13 · 10th to 90th $5 to $16
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 $6.76 Median $16.22 Typical High $16.22 | Professional | None | $6.76 | $16.22 | $16.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.59 Median $11.22 Typical High $19.95 | Facility | None | $7.59 | $11.22 | $19.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $13.49 | Professional | None | $8.51 | $12.88 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $11.48 Typical High $16.22 | Facility | None | $3.24 | $11.48 | $16.22 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $12.88 Typical High $16.22 | Professional | None | $8.71 | $12.88 | $16.22 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $30.20 | Professional | None | $8.51 | $12.88 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $9.55 Median $15.14 Typical High $724.44 | Facility | None | $9.55 | $15.14 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $851.14 | Professional | None | $12.02 | $15.14 | $851.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $12.88 | Professional | None | $8.51 | $8.51 | $12.88 |
Select Health Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $15.49 | Facility | None | $12.02 | $12.02 | $15.49 |
Select Health Setting Professional Modifier None Typical Low $7.94 Median $12.02 Typical High $13.18 | Professional | None | $7.94 | $12.02 | $13.18 |
United Setting Professional Modifier None Typical Low $4.68 Median $5.01 Typical High $8.13 | Professional | None | $4.68 | $5.01 | $8.13 |
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 $3.39 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $3.39 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $1.35 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $1.00 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $0.68 | $1.62 | $1.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $7.94 Median $8.91 Typical High $9.33 | Professional | 78 · Unplanned return to OR | $7.94 | $8.91 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $3.39 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $1.35 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $1.00 | $2.40 | $2.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $0.68 | $1.62 | $1.62 |
Where Idaho sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 3rd of 51
$12.59
HI $12.59DE $6.03
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.