How much rates vary
Facilitymedian $14 · 10th to 90th $5 to $26Professionalmedian $14 · 10th to 90th $11 to $17
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 $11.75 Median $14.45 Typical High $14.45 | Professional | None | $11.75 | $14.45 | $14.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.47 Median $9.12 Typical High $41.69 | Facility | None | $4.47 | $9.12 | $41.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $12.88 Median $13.80 Typical High $23.99 | Professional | None | $12.88 | $13.80 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.60 Typical High $29.51 | Facility | None | $16.22 | $16.60 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Moda Health Setting Facility Modifier None Typical Low $11.48 Median $14.45 Typical High $17.38 | Facility | None | $11.48 | $14.45 | $17.38 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $17.38 | Professional | None | $11.48 | $15.49 | $17.38 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $14.79 | Professional | None | $12.59 | $14.79 | $14.79 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $21.38 | Facility | None | $12.88 | $16.22 | $21.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $16.60 | Professional | None | $13.80 | $14.45 | $16.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $3.98 Median $8.13 Typical High $41.69 | Facility | None | $3.98 | $8.13 | $41.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | None | $12.88 | $13.80 | $13.80 |
Select Health Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $24.55 | Facility | None | $11.48 | $11.48 | $24.55 |
Select Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | None | $11.48 | $11.48 | $16.60 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | None | $13.80 | $13.80 | $14.79 |
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 $5.89 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $5.89 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.34 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $1.78 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.17 | $1.45 | $1.45 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $8.91 Median $15.85 Typical High $16.60 | Professional | 78 · Unplanned return to OR | $8.91 | $15.85 | $16.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $7.59 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.02 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $2.29 | $2.63 | $2.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.51 | $1.74 | $1.74 |
Where Idaho sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 15th of 51
$13.80
AK $20.89KY $11.48
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.