How much rates vary
Facilitymedian $33 · 10th to 90th $20 to $69Professionalmedian $28 · 10th to 90th $17 to $31
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 $34.67 Median $34.67 Typical High $46.77 | Facility | None | $34.67 | $34.67 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $30.90 | Professional | None | $25.12 | $30.90 | $30.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $79.43 | Facility | None | $28.84 | $39.81 | $79.43 |
BCBS Idaho Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $39.81 | Professional | None | $27.54 | $27.54 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $63.10 | Facility | None | $34.67 | $35.48 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $30.90 Typical High $91.20 | Facility | None | $20.89 | $30.90 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $30.90 | Professional | None | $18.20 | $20.89 | $30.90 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $18.20 | Professional | None | $15.49 | $18.20 | $18.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $19.05 Median $25.12 Typical High $30.90 | Facility | None | $19.05 | $25.12 | $30.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $30.90 | Professional | None | $16.60 | $19.95 | $30.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $30.90 | Professional | None | $27.54 | $29.51 | $30.90 |
Select Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $56.23 | Facility | None | $25.12 | $25.12 | $56.23 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | None | $25.12 | $25.12 | $27.54 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $26.30 | Professional | None | $16.60 | $16.60 | $26.30 |
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 $12.59 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $12.59 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.01 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $3.80 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.51 | $3.09 | $3.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.05 Median $19.05 Typical High $26.30 | Professional | 78 · Unplanned return to OR | $19.05 | $19.05 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $9.12 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.63 | $4.17 | $4.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.69 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.82 | $2.09 | $2.09 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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
$27.54
WY $39.81AZ $20.89
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.