How much rates vary
Facilitymedian $155 · 10th to 90th $93 to $257Professionalmedian $138 · 10th to 90th $76 to $204
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 $100.00 Median $138.04 Typical High $138.04 | Professional | None | $100.00 | $138.04 | $138.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $257.04 | Facility | None | $114.82 | $154.88 | $257.04 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $177.83 | Professional | None | $114.82 | $169.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $138.04 Typical High $162.18 | Facility | None | $48.98 | $138.04 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $169.82 | Professional | None | $107.15 | $138.04 | $169.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $117.49 Typical High $138.04 | Professional | None | $30.20 | $117.49 | $138.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $9,772.37 | Facility | None | $120.23 | $204.17 | $9,772.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $11,481.54 | Professional | None | $162.18 | $204.17 | $11,481.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $234.42 | Facility | None | $151.36 | $154.88 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $208.93 | Facility | None | $154.88 | $162.18 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $177.83 | Professional | None | $104.71 | $162.18 | $177.83 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $112.20 | Professional | None | $69.18 | $75.86 | $112.20 |
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 $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
Where Idaho sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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
$138
HI $204CO $85.11
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.