How much rates vary
Facilitymedian $76 · 10th to 90th $39 to $126Professionalmedian $68 · 10th to 90th $28 to $100
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 $52.48 Median $67.61 Typical High $67.61 | Professional | None | $52.48 | $67.61 | $67.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $128.82 | Facility | None | $61.66 | $75.86 | $128.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $87.10 | Professional | None | $54.95 | $83.18 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Facility | None | $38.90 | $38.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $67.61 Typical High $77.62 | Facility | None | $18.62 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $83.18 | Professional | None | $52.48 | $67.61 | $83.18 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $67.61 | Professional | None | $30.20 | $58.88 | $67.61 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $4,786.30 | Facility | None | $52.48 | $100.00 | $4,786.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $5,623.41 | Professional | None | $79.43 | $100.00 | $5,623.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $114.82 | Facility | None | $74.13 | $75.86 | $114.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | None | $54.95 | $54.95 | $83.18 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $79.43 Typical High $102.33 | Facility | None | $72.44 | $79.43 | $102.33 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $85.11 | Professional | None | $51.29 | $79.43 | $85.11 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $43.65 | Professional | None | $26.92 | $28.84 | $43.65 |
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 $26.30 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $6.76 | $6.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $58.88 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $51.29 | $58.88 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $6.76 | $6.76 |
Where Idaho sits
The same service costs 3.0 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· 4th of 51
$67.61
HI $83.18DE $28.18
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.