How much rates vary
Facilitymedian $31 · 10th to 90th $11 to $63Professionalmedian $17 · 10th to 90th $11 to $24
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $17.38 | Professional | None | $11.75 | $11.75 | $17.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $63.10 | Facility | None | $26.30 | $43.65 | $63.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $19.95 Median $22.39 Typical High $23.99 | Professional | None | $19.95 | $22.39 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | None | $40.74 | $40.74 | $42.66 |
Moda Health Setting Facility Modifier None Typical Low $11.75 Median $15.85 Typical High $5,495.41 | Facility | None | $11.75 | $15.85 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $22.91 | Professional | None | $11.75 | $11.75 | $22.91 |
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 $11.48 Median $13.18 Typical High $19.05 | Facility | None | $11.48 | $13.18 | $19.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $11.48 Median $13.18 Typical High $21.88 | Professional | None | $11.48 | $13.18 | $21.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $22.39 | Professional | None | $15.85 | $19.95 | $22.39 |
Select Health Setting Facility Modifier None Typical Low $10.47 Median $10.72 Typical High $58.88 | Facility | None | $10.47 | $10.72 | $58.88 |
Select Health Setting Professional Modifier None Typical Low $10.47 Median $15.14 Typical High $30.90 | Professional | None | $10.47 | $15.14 | $30.90 |
United Setting Professional Modifier None Typical Low $12.59 Median $15.14 Typical High $26.92 | Professional | None | $12.59 | $15.14 | $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 $5.89 Median $5.89 Typical High $8.32 | Professional | 52 · Reduced service | $5.89 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $3.31 | Professional | 53 · Discontinued | $2.34 | $2.34 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 54 · Surgery only | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.51 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.13 Median $15.85 Typical High $16.60 | Professional | 78 · Unplanned return to OR | $14.13 | $15.85 | $16.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $5.89 Typical High $8.32 | Professional | 52 · Reduced service | $5.89 | $5.89 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $3.31 | Professional | 53 · Discontinued | $2.34 | $2.34 | $3.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 54 · Surgery only | $8.71 | $8.71 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.51 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.66 |
Where Idaho sits
The same service costs 3.3 times more in Alaska 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· 14th of 51
$18.20
AK $37.15DE $11.22
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.