How much rates vary
Facilitymedian $162 · 10th to 90th $115 to $275Professionalmedian $148 · 10th to 90th $78 to $214
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 $114.82 Median $147.91 Typical High $147.91 | Professional | None | $114.82 | $147.91 | $147.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $275.42 | Facility | None | $134.90 | $165.96 | $275.42 |
BCBS Idaho Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $190.55 | Professional | None | $120.23 | $181.97 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $147.91 Typical High $173.78 | Facility | None | $50.12 | $147.91 | $173.78 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | None | $114.82 | $154.88 | $181.97 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $128.82 Typical High $147.91 | Professional | None | $30.20 | $128.82 | $147.91 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $10,232.93 | Facility | None | $138.04 | $213.80 | $10,232.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $12,022.64 | Professional | None | $173.78 | $213.80 | $12,022.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $245.47 | Facility | None | $162.18 | $165.96 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $181.97 | Professional | None | $120.23 | $120.23 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $218.78 | Facility | None | $173.78 | $173.78 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $186.21 | Professional | None | $112.20 | $173.78 | $186.21 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $114.82 | Professional | None | $70.79 | $77.62 | $114.82 |
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 $56.23 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $22.91 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $14.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $22.91 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $14.79 |
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· 13th of 51
$148
MT $178FL $85.11
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.