How much rates vary
Facilitymedian $126 · 10th to 90th $81 to $214Professionalmedian $112 · 10th to 90th $59 to $166
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 $87.10 Median $112.20 Typical High $112.20 | Professional | None | $87.10 | $112.20 | $112.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $213.80 | Facility | None | $102.33 | $125.89 | $213.80 |
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 $81.28 Median $81.28 Typical High $87.10 | Facility | None | $81.28 | $81.28 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $41.69 Median $112.20 Typical High $131.83 | Facility | None | $41.69 | $112.20 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $138.04 | Professional | None | $87.10 | $117.49 | $138.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $95.50 Typical High $112.20 | Professional | None | $30.20 | $95.50 | $112.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $7,943.28 | Facility | None | $112.20 | $165.96 | $7,943.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $9,332.54 | Professional | None | $131.83 | $165.96 | $9,332.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $190.55 | Facility | None | $123.03 | $125.89 | $190.55 |
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 $131.83 Median $131.83 Typical High $173.78 | Facility | None | $131.83 | $131.83 | $173.78 |
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 $79.43 Median $79.43 Typical High $85.11 | Facility | None | $79.43 | $79.43 | $85.11 |
United Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $95.50 | Professional | None | $58.88 | $64.57 | $95.50 |
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 5.1 times more in Kansas 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· 12th of 51
$112
KS $309FL $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.