How much rates vary
Facilitymedian $126 · 10th to 90th $78 to $214Professionalmedian $112 · 10th to 90th $56 to $162
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 $83.18 Median $112.20 Typical High $112.20 | Professional | None | $83.18 | $112.20 | $112.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $218.78 | Facility | None | $102.33 | $125.89 | $218.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $144.54 | Professional | None | $91.20 | $138.04 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $112.20 Typical High $131.83 | Facility | None | $38.90 | $112.20 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $138.04 | Professional | None | $87.10 | $112.20 | $138.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $93.33 Typical High $109.65 | Professional | None | $30.20 | $93.33 | $109.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $7,762.47 | Facility | None | $97.72 | $162.18 | $7,762.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $9,120.11 | Professional | None | $138.04 | $162.18 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $186.21 | Facility | None | $123.03 | $125.89 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $165.96 | Facility | None | $123.03 | $131.83 | $165.96 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $144.54 | Professional | None | $85.11 | $131.83 | $144.54 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $89.13 | Professional | None | $56.23 | $60.26 | $89.13 |
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 $43.65 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $17.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $11.22 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $95.50 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $85.11 | $95.50 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $43.65 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $17.38 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $11.22 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii 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· 13th of 51
$112
HI $174DE $56.23
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.