How much rates vary
Facilitymedian $112 · 10th to 90th $65 to $186Professionalmedian $100 · 10th to 90th $49 to $148
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 $77.62 Median $100.00 Typical High $100.00 | Professional | None | $77.62 | $100.00 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $186.21 | Facility | None | $83.18 | $112.20 | $186.21 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $128.82 | Professional | None | $81.28 | $123.03 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Facility | None | $83.18 | $83.18 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $100.00 Typical High $117.49 | Facility | None | $31.62 | $100.00 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $123.03 | Professional | None | $77.62 | $104.71 | $123.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $85.11 Typical High $100.00 | Professional | None | $30.20 | $85.11 | $100.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $147.91 Typical High $7,079.46 | Facility | None | $77.62 | $147.91 | $7,079.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $8,317.64 | Professional | None | $117.49 | $147.91 | $8,317.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $169.82 | Facility | None | $109.65 | $112.20 | $169.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $123.03 | Professional | None | $81.28 | $81.28 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $151.36 | Facility | None | $107.15 | $117.49 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $128.82 | Professional | None | $75.86 | $117.49 | $128.82 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
United Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $72.44 | Professional | None | $44.67 | $48.98 | $72.44 |
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 $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $10.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $87.10 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $77.62 | $87.10 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $10.00 |
Where Idaho sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 10th of 51
$100
HI $186DC $52.48
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.