How much rates vary
Facilitymedian $13 · 10th to 90th $8 to $26Professionalmedian $14 · 10th to 90th $6 to $18
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 $7.59 Median $18.20 Typical High $18.20 | Professional | None | $7.59 | $18.20 | $18.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.94 Median $12.02 Typical High $21.88 | Facility | None | $7.94 | $12.02 | $21.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $15.14 | Professional | None | $9.55 | $14.45 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $8.32 Median $12.88 Typical High $18.20 | Facility | None | $8.32 | $12.88 | $18.20 |
Moda Health Setting Professional Modifier None Typical Low $9.77 Median $14.45 Typical High $18.20 | Professional | None | $9.77 | $14.45 | $18.20 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $30.20 | Professional | None | $9.55 | $9.55 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $10.72 Median $16.98 Typical High $812.83 | Facility | None | $10.72 | $16.98 | $812.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.80 Median $16.98 Typical High $954.99 | Professional | None | $13.80 | $16.98 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $14.45 | Professional | None | $9.55 | $9.55 | $14.45 |
Select Health Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Select Health Setting Professional Modifier None Typical Low $8.91 Median $13.80 Typical High $15.14 | Professional | None | $8.91 | $13.80 | $15.14 |
United Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $9.55 | Professional | None | $5.25 | $5.75 | $9.55 |
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 $3.80 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $3.80 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $1.51 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $1.12 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.76 | $1.82 | $1.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $8.91 Median $10.00 Typical High $10.47 | Professional | 78 · Unplanned return to OR | $8.91 | $10.00 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.80 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $3.80 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $1.51 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $1.15 | $2.75 | $2.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.76 | $1.82 | $1.82 |
Where Idaho sits
The same service costs 2.2 times more in Hawaii than in Maine. 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· 2nd of 51
$14.45
HI $15.49ME $6.92
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.