How much rates vary
Facilitymedian $100 · 10th to 90th $68 to $166Professionalmedian $89 · 10th to 90th $47 to $132
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 $69.18 Median $89.13 Typical High $89.13 | Professional | None | $69.18 | $89.13 | $89.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $165.96 | Facility | None | $81.28 | $100.00 | $165.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $114.82 | Professional | None | $72.44 | $109.65 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $89.13 Typical High $104.71 | Facility | None | $30.20 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $109.65 | Professional | None | $69.18 | $93.33 | $109.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $89.13 | Professional | None | $30.20 | $77.62 | $89.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $83.18 Median $131.83 Typical High $6,309.57 | Facility | None | $83.18 | $131.83 | $6,309.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $7,413.10 | Professional | None | $104.71 | $131.83 | $7,413.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $151.36 | Facility | None | $97.72 | $100.00 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $109.65 | Professional | None | $72.44 | $72.44 | $109.65 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $134.90 | Facility | None | $104.71 | $104.71 | $134.90 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $114.82 | Professional | None | $67.61 | $104.71 | $114.82 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
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 $34.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.92 | $8.91 | $8.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $77.62 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $69.18 | $77.62 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $34.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.92 | $8.91 | $8.91 |
Where Idaho sits
The same service costs 2.1 times more in Montana 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· 12th of 51
$89.13
MT $107FL $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.