How much rates vary
Facilitymedian $71 · 10th to 90th $62 to $182Professionalmedian $72 · 10th to 90th $60 to $100
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 $60.26 Median $74.13 Typical High $74.13 | Professional | None | $60.26 | $74.13 | $74.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $147.91 | Facility | None | $61.66 | $69.18 | $147.91 |
BCBS Idaho Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $100.00 | Professional | None | $61.66 | $69.18 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $151.36 | Facility | None | $83.18 | $85.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $95.50 | Facility | None | $60.26 | $74.13 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $95.50 | Professional | None | $60.26 | $85.11 | $95.50 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | None | $97.72 | $97.72 | $114.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $117.49 | Facility | None | $66.07 | $89.13 | $117.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $91.20 | Professional | None | $74.13 | $75.86 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $363.08 | Facility | None | $66.07 | $199.53 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | None | $66.07 | $72.44 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $125.89 | Facility | None | $60.26 | $60.26 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $85.11 | Professional | None | $60.26 | $60.26 | $85.11 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | None | $77.62 | $77.62 | $85.11 |
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 $30.20 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $12.02 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $9.12 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $7.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $46.77 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $43.65 | $46.77 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.60 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $9.55 | $9.55 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 20th of 51
$72.44
HI $158CO $60.26
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.