How much rates vary
Facilitymedian $158 · 10th to 90th $98 to $269Professionalmedian $141 · 10th to 90th $71 to $209
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 $95.50 Median $141.25 Typical High $141.25 | Professional | None | $95.50 | $141.25 | $141.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $138.04 Median $158.49 Typical High $269.15 | Facility | None | $138.04 | $158.49 | $269.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $181.97 | Professional | None | $114.82 | $173.78 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Facility | None | $97.72 | $97.72 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $141.25 Typical High $165.96 | Facility | None | $46.77 | $141.25 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $173.78 | Professional | None | $109.65 | $154.88 | $173.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $120.23 Typical High $141.25 | Professional | None | $30.20 | $120.23 | $141.25 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $10,000.00 | Facility | None | $128.82 | $208.93 | $10,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $11,748.98 | Professional | None | $165.96 | $208.93 | $11,748.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $239.88 | Facility | None | $154.88 | $158.49 | $239.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $173.78 | Professional | None | $114.82 | $114.82 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $213.80 | Facility | None | $162.18 | $165.96 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $181.97 | Professional | None | $107.15 | $165.96 | $181.97 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $107.15 | Professional | None | $67.61 | $72.44 | $107.15 |
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 $54.95 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $14.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $123.03 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $109.65 | $123.03 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $14.13 |
Where Idaho sits
The same service costs 2.8 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· 10th of 51
$141
HI $195FL $70.79
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.