How much rates vary
Facilitymedian $11 · 10th to 90th $9 to $18Professionalmedian $10 · 10th to 90th $9 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 $8.71 Median $10.96 Typical High $10.96 | Professional | None | $8.71 | $10.96 | $10.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $8.91 Median $10.72 Typical High $18.20 | Facility | None | $8.91 | $10.72 | $18.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $9.55 Median $10.47 Typical High $16.22 | Professional | None | $9.55 | $10.47 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $12.30 Typical High $21.88 | Facility | None | $12.02 | $12.30 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $10.96 Typical High $10.96 | Facility | None | $8.71 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $10.72 Typical High $10.96 | Professional | None | $8.71 | $10.72 | $10.96 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $6.92 | Professional | None | $5.89 | $6.92 | $6.92 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $9.55 Median $10.00 Typical High $13.18 | Facility | None | $9.55 | $10.00 | $13.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $10.47 Typical High $10.96 | Professional | None | $8.51 | $10.47 | $10.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $7.41 Median $10.72 Typical High $18.20 | Facility | None | $7.41 | $10.72 | $18.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.55 Median $10.47 Typical High $10.96 | Professional | None | $9.55 | $10.47 | $10.96 |
Select Health Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $18.20 | Facility | None | $8.71 | $8.71 | $18.20 |
Select Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | None | $8.71 | $8.71 | $8.91 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | None | $8.71 | $8.71 | $9.12 |
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 $4.37 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $4.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $1.74 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.32 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.87 | $1.07 | $1.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.31 Median $6.76 Typical High $11.48 | Professional | 78 · Unplanned return to OR | $6.31 | $6.76 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $4.68 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $1.86 | $2.14 | $2.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.41 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.93 | $1.07 | $1.07 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 3rd of 51
$10.47
WY $16.22MS $8.71
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.