How much rates vary
Facilitymedian $204 · 10th to 90th $132 to $347Professionalmedian $182 · 10th to 90th $100 to $269
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 $141.25 Median $181.97 Typical High $181.97 | Professional | None | $141.25 | $181.97 | $181.97 |
BCBS Idaho Setting Facility Modifier None Typical Low $165.96 Median $204.17 Typical High $346.74 | Facility | None | $165.96 | $204.17 | $346.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $234.42 | Professional | None | $147.91 | $223.87 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Facility | None | $134.90 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $181.97 Typical High $213.80 | Facility | None | $64.57 | $181.97 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $223.87 | Professional | None | $141.25 | $190.55 | $223.87 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $154.88 Typical High $181.97 | Professional | None | $30.20 | $154.88 | $181.97 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $12,882.50 | Facility | None | $162.18 | $269.15 | $12,882.50 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $15,135.61 | Professional | None | $223.87 | $269.15 | $15,135.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $309.03 | Facility | None | $199.53 | $204.17 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | None | $147.91 | $147.91 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $213.80 Typical High $275.42 | Facility | None | $204.17 | $213.80 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $234.42 | Professional | None | $138.04 | $213.80 | $234.42 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $151.36 | Professional | None | $93.33 | $100.00 | $151.36 |
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 $70.79 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $28.18 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $18.20 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $70.79 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $28.18 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $18.20 |
Where Idaho sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 15th of 51
$182
KS $389NJ $100
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.