How much rates vary
Facilitymedian $91 · 10th to 90th $58 to $151Professionalmedian $81 · 10th to 90th $44 to $120
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 $63.10 Median $81.28 Typical High $81.28 | Professional | None | $63.10 | $81.28 | $81.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $151.36 | Facility | None | $67.61 | $91.20 | $151.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $104.71 | Professional | None | $66.07 | $100.00 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $69.18 | Facility | None | $63.10 | $63.10 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $81.28 Typical High $95.50 | Facility | None | $28.18 | $81.28 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $100.00 | Professional | None | $63.10 | $81.28 | $100.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $81.28 | Professional | None | $30.20 | $69.18 | $81.28 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $120.23 Typical High $5,754.40 | Facility | None | $70.79 | $120.23 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $6,760.83 | Professional | None | $95.50 | $120.23 | $6,760.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $138.04 | Facility | None | $89.13 | $91.20 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $100.00 | Professional | None | $66.07 | $66.07 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $95.50 Typical High $123.03 | Facility | None | $89.13 | $95.50 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $104.71 | Professional | None | $61.66 | $95.50 | $104.71 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
United Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $64.57 | Professional | None | $40.74 | $43.65 | $64.57 |
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 $31.62 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $9.55 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.31 | $8.13 | $8.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $31.62 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $12.59 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $9.55 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.31 | $8.13 | $8.13 |
Where Idaho sits
The same service costs 3.2 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· 13th of 51
$81.28
HI $148NJ $45.71
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.