How much rates vary
Facilitymedian $39 · 10th to 90th $22 to $65Professionalmedian $35 · 10th to 90th $16 to $51
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 $19.05 Median $34.67 Typical High $34.67 | Professional | None | $19.05 | $34.67 | $34.67 |
BCBS Idaho Setting Facility Modifier None Typical Low $30.90 Median $38.90 Typical High $64.57 | Facility | None | $30.90 | $38.90 | $64.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $44.67 | Professional | None | $28.18 | $42.66 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $24.55 | Facility | None | $22.39 | $22.39 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Moda Health Setting Facility Modifier None Typical Low $9.55 Median $34.67 Typical High $40.74 | Facility | None | $9.55 | $34.67 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $42.66 | Professional | None | $26.92 | $34.67 | $42.66 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $34.67 | Professional | None | $29.51 | $30.20 | $34.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $23.99 Median $51.29 Typical High $2,454.71 | Facility | None | $23.99 | $51.29 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $2,884.03 | Professional | None | $40.74 | $51.29 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $58.88 | Facility | None | $38.02 | $38.90 | $58.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $42.66 | Professional | None | $28.18 | $28.18 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $40.74 Typical High $52.48 | Facility | None | $37.15 | $40.74 | $52.48 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $40.74 Typical High $40.74 | Professional | None | $26.30 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $21.88 | Professional | None | $13.80 | $14.79 | $21.88 |
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 $13.18 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $13.18 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $5.25 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $3.89 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.63 | $3.47 | $3.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $30.20 Typical High $31.62 | Professional | 78 · Unplanned return to OR | $26.92 | $30.20 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $13.49 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $5.37 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.07 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.69 | $3.47 | $3.47 |
Where Idaho sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 4th of 51
$34.67
HI $60.26FL $16.22
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.