How much rates vary
Facilitymedian $148 · 10th to 90th $98 to $251Professionalmedian $132 · 10th to 90th $71 to $191
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 $102.33 Median $131.83 Typical High $131.83 | Professional | None | $102.33 | $131.83 | $131.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $251.19 | Facility | None | $120.23 | $147.91 | $251.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $169.82 | Professional | None | $107.15 | $162.18 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Facility | None | $97.72 | $97.72 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $131.83 Typical High $154.88 | Facility | None | $48.98 | $131.83 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $162.18 | Professional | None | $102.33 | $138.04 | $162.18 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $114.82 Typical High $131.83 | Professional | None | $30.20 | $114.82 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $9,332.54 | Facility | None | $131.83 | $190.55 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $10,715.19 | Professional | None | $162.18 | $190.55 | $10,715.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $218.78 | Facility | None | $144.54 | $147.91 | $218.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $204.17 | Facility | None | $154.88 | $154.88 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $169.82 | Professional | None | $100.00 | $154.88 | $169.82 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $112.20 | Professional | None | $69.18 | $75.86 | $112.20 |
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 $51.29 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $13.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $13.18 |
Where Idaho sits
The same service costs 3.2 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
$132
HI $224FL $70.79
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.