How much rates vary
Facilitymedian $93 · 10th to 90th $65 to $155Professionalmedian $83 · 10th to 90th $47 to $120
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 $64.57 Median $83.18 Typical High $83.18 | Professional | None | $64.57 | $83.18 | $83.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $93.33 Typical High $154.88 | Facility | None | $72.44 | $93.33 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $107.15 | Professional | None | $67.61 | $102.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $83.18 Typical High $97.72 | Facility | None | $30.20 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $102.33 | Professional | None | $64.57 | $87.10 | $102.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $83.18 | Professional | None | $30.20 | $72.44 | $83.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $5,754.40 | Facility | None | $75.86 | $120.23 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $6,760.83 | Professional | None | $102.33 | $120.23 | $6,760.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $138.04 | Facility | None | $91.20 | $93.33 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $123.03 | Facility | None | $95.50 | $97.72 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $107.15 | Professional | None | $63.10 | $97.72 | $107.15 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | None | $63.10 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $69.18 | Professional | None | $43.65 | $46.77 | $69.18 |
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 $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $8.32 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $8.32 |
Where Idaho sits
The same service costs 4.4 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· 13th of 51
$83.18
HI $219FL $50.12
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.