How much rates vary
Facilitymedian $132 · 10th to 90th $87 to $219Professionalmedian $117 · 10th to 90th $63 to $174
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 $81.28 Median $117.49 Typical High $117.49 | Professional | None | $81.28 | $117.49 | $117.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $223.87 | Facility | None | $104.71 | $131.83 | $223.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $151.36 | Professional | None | $97.72 | $144.54 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Facility | None | $87.10 | $87.10 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $117.49 Typical High $138.04 | Facility | None | $43.65 | $117.49 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | None | $91.20 | $117.49 | $144.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $102.33 Typical High $120.23 | Professional | None | $30.20 | $102.33 | $120.23 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $8,317.64 | Facility | None | $117.49 | $173.78 | $8,317.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $9,772.37 | Professional | None | $138.04 | $173.78 | $9,772.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $199.53 | Facility | None | $128.82 | $131.83 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $144.54 | Professional | None | $97.72 | $97.72 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Facility | None | $138.04 | $138.04 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $151.36 | Professional | None | $89.13 | $138.04 | $151.36 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Facility | None | $91.20 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $100.00 | Professional | None | $63.10 | $67.61 | $100.00 |
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 $45.71 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $18.20 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $11.75 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $102.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $91.20 | $102.33 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $18.20 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $11.75 |
Where Idaho sits
The same service costs 5.0 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· 15th of 51
$117
HI $316DE $63.10
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.