How much rates vary
Facilitymedian $20 · 10th to 90th $12 to $34Professionalmedian $18 · 10th to 90th $10 to $30
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 $14.13 Median $18.20 Typical High $18.20 | Professional | None | $14.13 | $18.20 | $18.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.60 Median $20.42 Typical High $33.88 | Facility | None | $16.60 | $20.42 | $33.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $14.79 Median $22.39 Typical High $23.44 | Professional | None | $14.79 | $22.39 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.13 | Facility | None | $13.49 | $13.49 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Moda Health Setting Facility Modifier None Typical Low $6.31 Median $18.20 Typical High $21.38 | Facility | None | $6.31 | $18.20 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $22.39 | Professional | None | $14.13 | $19.05 | $22.39 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $30.20 | Professional | None | $15.49 | $18.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $15.85 Median $26.92 Typical High $1,288.25 | Facility | None | $15.85 | $26.92 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $1,513.56 | Professional | None | $21.38 | $26.92 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $19.95 Median $20.42 Typical High $30.90 | Facility | None | $19.95 | $20.42 | $30.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $22.39 | Professional | None | $14.79 | $14.79 | $22.39 |
Select Health Setting Facility Modifier None Typical Low $19.95 Median $21.38 Typical High $27.54 | Facility | None | $19.95 | $21.38 | $27.54 |
Select Health Setting Professional Modifier None Typical Low $13.80 Median $21.38 Typical High $23.44 | Professional | None | $13.80 | $21.38 | $23.44 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $14.45 | Professional | None | $8.91 | $9.77 | $14.45 |
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 $7.08 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $7.08 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $2.82 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.14 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.41 | $1.82 | $1.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.13 Median $15.85 Typical High $16.60 | Professional | 78 · Unplanned return to OR | $14.13 | $15.85 | $16.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $7.08 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $2.82 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.14 | $2.75 | $2.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.41 | $1.82 | $1.82 |
Where Idaho sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 9th of 51
$18.20
AR $22.91KS $9.12
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.