How much rates vary
Facilitymedian $151 · 10th to 90th $89 to $251Professionalmedian $135 · 10th to 90th $65 to $195
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 $93.33 Median $134.90 Typical High $134.90 | Professional | None | $93.33 | $134.90 | $134.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $251.19 | Facility | None | $123.03 | $151.36 | $251.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $173.78 | Professional | None | $109.65 | $165.96 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $95.50 | Facility | None | $89.13 | $89.13 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $134.90 Typical High $158.49 | Facility | None | $45.71 | $134.90 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $165.96 | Professional | None | $104.71 | $134.90 | $165.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $117.49 Typical High $134.90 | Professional | None | $30.20 | $117.49 | $134.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $9,332.54 | Facility | None | $125.89 | $194.98 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $10,964.78 | Professional | None | $158.49 | $194.98 | $10,964.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $223.87 | Facility | None | $147.91 | $151.36 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | None | $109.65 | $109.65 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $199.53 | Facility | None | $158.49 | $158.49 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $169.82 | Professional | None | $102.33 | $158.49 | $169.82 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $104.71 | Professional | None | $64.57 | $70.79 | $104.71 |
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 $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $20.89 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $13.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $102.33 | $114.82 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $20.89 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $13.49 |
Where Idaho sits
The same service costs 2.8 times more in Kansas 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· 13th of 51
$135
KS $178DE $64.57
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.