How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $48Professionalmedian $10 · 10th to 90th $8 to $11
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 $8.13 Median $10.23 Typical High $10.23 | Professional | None | $8.13 | $10.23 | $10.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $14.45 Median $30.20 Typical High $57.54 | Facility | None | $14.45 | $30.20 | $57.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $35.48 | Professional | None | $8.91 | $9.77 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $20.89 | Facility | None | $11.48 | $11.48 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $10.23 Typical High $10.96 | Facility | None | $8.13 | $10.23 | $10.96 |
Moda Health Setting Professional Modifier None Typical Low $8.13 Median $10.23 Typical High $10.96 | Professional | None | $8.13 | $10.23 | $10.96 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $9.77 | Professional | None | $8.32 | $9.77 | $9.77 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $8.91 Median $10.00 Typical High $13.18 | Facility | None | $8.91 | $10.00 | $13.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $10.23 Typical High $10.47 | Professional | None | $8.51 | $10.23 | $10.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $14.45 Median $19.95 Typical High $36.31 | Facility | None | $14.45 | $19.95 | $36.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $10.23 | Professional | None | $8.91 | $9.77 | $10.23 |
Select Health Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $54.95 | Facility | None | $8.13 | $8.13 | $54.95 |
Select Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | None | $8.13 | $8.13 | $11.75 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.77 | Professional | None | $8.71 | $8.71 | $9.77 |
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 $4.17 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $4.17 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.66 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.23 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.83 | $1.02 | $1.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.31 Median $23.99 Typical High $25.12 | Professional | 78 · Unplanned return to OR | $6.31 | $23.99 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $4.79 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $1.91 | $2.19 | $2.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.45 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.95 | $1.10 | $1.10 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 8th of 51
$9.77
WY $15.49GA $8.13
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.