How much rates vary
Facilitymedian $23 · 10th to 90th $14 to $35Professionalmedian $20 · 10th to 90th $14 to $30
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 Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $16.98 | Professional | None | $12.88 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.29 | $1.41 | $1.41 |
BCBS Idaho Setting Facility Modifier None Typical Low $19.50 Median $27.54 Typical High $37.15 | Facility | None | $19.50 | $27.54 | $37.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $30.90 | Professional | None | $23.44 | $29.51 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Moda Health Setting Facility Modifier None Typical Low $12.88 Median $14.13 Typical High $22.91 | Facility | None | $12.88 | $14.13 | $22.91 |
Moda Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $28.18 | Professional | None | $14.13 | $14.13 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.29 | $1.41 | $1.41 |
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 $16.98 Median $19.05 Typical High $27.54 | Facility | None | $16.98 | $19.05 | $27.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $32.36 | Professional | None | $16.98 | $19.05 | $32.36 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $2.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $23.44 Median $25.12 Typical High $37.15 | Facility | None | $23.44 | $25.12 | $37.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | None | $19.95 | $23.44 | $23.44 |
Select Health Setting Facility Modifier None Typical Low $15.14 Median $15.49 Typical High $28.18 | Facility | None | $15.14 | $15.49 | $28.18 |
Select Health Setting Professional Modifier None Typical Low $14.45 Median $17.78 Typical High $28.84 | Professional | None | $14.45 | $17.78 | $28.84 |
United Setting Professional Modifier None Typical Low $15.49 Median $19.95 Typical High $26.92 | Professional | None | $15.49 | $19.95 | $26.92 |
11 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 $6.31 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.31 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.51 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $1.91 | $2.09 | $2.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.50 Median $22.91 Typical High $24.55 | Professional | 78 · Unplanned return to OR | $19.50 | $22.91 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.31 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.57 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $1.91 | $2.09 | $2.09 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 22 · Increased work | $30.90 | $30.90 | $30.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 54 · Surgery only | $19.50 | $19.50 | $19.50 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 63 · Small infant | $30.90 | $30.90 | $30.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 78 · Unplanned return to OR | $20.89 | $20.89 | $20.89 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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
$20.42
AK $38.90LA $13.80
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.