How much rates vary
Facilitymedian $93 · 10th to 90th $47 to $155Professionalmedian $85 · 10th to 90th $34 to $123
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 $64.57 Median $85.11 Typical High $85.11 | Professional | None | $64.57 | $85.11 | $85.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $154.88 | Facility | None | $75.86 | $93.33 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $107.15 | Professional | None | $69.18 | $102.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $23.44 Median $83.18 Typical High $97.72 | Facility | None | $23.44 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $102.33 | Professional | None | $64.57 | $89.13 | $102.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $83.18 | Professional | None | $30.20 | $70.79 | $83.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $5,888.44 | Facility | None | $66.07 | $123.03 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $6,918.31 | Professional | None | $97.72 | $123.03 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $141.25 | Facility | None | $91.20 | $93.33 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $102.33 | Professional | None | $69.18 | $69.18 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $125.89 | Facility | None | $91.20 | $97.72 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $107.15 | Professional | None | $63.10 | $97.72 | $107.15 |
United Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | None | $19.05 | $19.05 | $36.31 |
United Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $53.70 | Professional | None | $32.36 | $36.31 | $53.70 |
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 $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $12.88 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $8.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $64.57 | $72.44 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $12.88 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $8.51 |
Where Idaho sits
The same service costs 2.9 times more in Kansas than in Delaware. 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
$85.11
KS $97.72DE $33.88
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.