How much rates vary
Facilitymedian $107 · 10th to 90th $58 to $182Professionalmedian $95 · 10th to 90th $43 to $141
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 $58.88 Median $95.50 Typical High $100.00 | Professional | None | $58.88 | $95.50 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $181.97 | Facility | None | $79.43 | $107.15 | $181.97 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $123.03 | Professional | None | $79.43 | $117.49 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Facility | None | $57.54 | $57.54 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $95.50 Typical High $112.20 | Facility | None | $28.84 | $95.50 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $117.49 | Professional | None | $74.13 | $104.71 | $117.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $97.72 | Professional | None | $30.20 | $83.18 | $97.72 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $6,760.83 | Facility | None | $72.44 | $141.25 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $7,943.28 | Professional | None | $112.20 | $141.25 | $7,943.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $162.18 | Facility | None | $104.71 | $107.15 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | None | $79.43 | $79.43 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $144.54 | Facility | None | $104.71 | $112.20 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $120.23 | Professional | None | $72.44 | $112.20 | $120.23 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $66.07 | Professional | None | $41.69 | $44.67 | $66.07 |
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 $37.15 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $37.15 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $9.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $74.13 | $83.18 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $37.15 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $9.55 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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
$95.50
HI $117DE $44.67
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.