How much rates vary
Facilitymedian $117 · 10th to 90th $65 to $200Professionalmedian $107 · 10th to 90th $47 to $155
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 $107.15 Typical High $107.15 | Professional | None | $81.28 | $107.15 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $199.53 | Facility | None | $95.50 | $117.49 | $199.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $134.90 | Professional | None | $87.10 | $128.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $70.79 | Facility | None | $64.57 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $107.15 Typical High $123.03 | Facility | None | $33.11 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $128.82 | Professional | None | $81.28 | $112.20 | $128.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $93.33 Typical High $107.15 | Professional | None | $30.20 | $93.33 | $107.15 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $89.13 Median $154.88 Typical High $7,413.10 | Facility | None | $89.13 | $154.88 | $7,413.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $8,709.64 | Professional | None | $123.03 | $154.88 | $8,709.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $177.83 | Facility | None | $114.82 | $117.49 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $128.82 | Professional | None | $87.10 | $87.10 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $123.03 Typical High $158.49 | Facility | None | $114.82 | $123.03 | $158.49 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $134.90 | Professional | None | $81.28 | $123.03 | $134.90 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $75.86 | Professional | None | $47.86 | $51.29 | $75.86 |
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 $40.74 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $40.74 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $10.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $40.74 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $10.72 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin 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· 10th of 51
$107
WI $132DE $46.77
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.