How much rates vary
Facilitymedian $123 · 10th to 90th $72 to $204Professionalmedian $112 · 10th to 90th $54 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 $85.11 Median $112.20 Typical High $112.20 | Professional | None | $85.11 | $112.20 | $112.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $204.17 | Facility | None | $100.00 | $123.03 | $204.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $141.25 | Professional | None | $91.20 | $134.90 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $83.18 | Facility | None | $75.86 | $75.86 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $112.20 Typical High $128.82 | Facility | None | $34.67 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $134.90 | Professional | None | $85.11 | $117.49 | $134.90 |
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 $87.10 Median $162.18 Typical High $7,762.47 | Facility | None | $87.10 | $162.18 | $7,762.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $9,120.11 | Professional | None | $128.82 | $162.18 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $186.21 | Facility | None | $120.23 | $123.03 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $128.82 Typical High $165.96 | Facility | None | $120.23 | $128.82 | $165.96 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $141.25 | Professional | None | $85.11 | $128.82 | $141.25 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
United Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $79.43 | Professional | None | $50.12 | $53.70 | $79.43 |
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 $42.66 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $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 $42.66 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $42.66 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $12.88 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $11.22 | $11.22 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii 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· 5th of 51
$112
HI $170NJ $54.95
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.