How much rates vary
Facilitymedian $98 · 10th to 90th $65 to $166Professionalmedian $89 · 10th to 90th $49 to $129
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 $67.61 Median $89.13 Typical High $89.13 | Professional | None | $67.61 | $89.13 | $89.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $165.96 | Facility | None | $79.43 | $97.72 | $165.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $112.20 | Professional | None | $72.44 | $107.15 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $77.62 | Facility | None | $72.44 | $72.44 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $89.13 Typical High $102.33 | Facility | None | $31.62 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $107.15 | Professional | None | $67.61 | $93.33 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $87.10 | Professional | None | $30.20 | $74.13 | $87.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $6,165.95 | Facility | None | $77.62 | $128.82 | $6,165.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $7,244.36 | Professional | None | $102.33 | $128.82 | $7,244.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $147.91 | Facility | None | $95.50 | $97.72 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $107.15 | Professional | None | $72.44 | $72.44 | $107.15 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $131.83 | Facility | None | $100.00 | $102.33 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $112.20 | Professional | None | $67.61 | $102.33 | $112.20 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
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 $33.88 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $8.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $75.86 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $67.61 | $75.86 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $8.91 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 12th of 51
$89.13
HI $166FL $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.