How much rates vary
Facilitymedian $115 · 10th to 90th $63 to $191Professionalmedian $105 · 10th to 90th $46 to $151
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 $63.10 Median $104.71 Typical High $104.71 | Professional | None | $63.10 | $104.71 | $104.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $190.55 | Facility | None | $91.20 | $114.82 | $190.55 |
BCBS Idaho Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $131.83 | Professional | None | $85.11 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $69.18 | Facility | None | $63.10 | $63.10 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $104.71 Typical High $120.23 | Facility | None | $30.90 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $125.89 | Professional | None | $79.43 | $104.71 | $125.89 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $91.20 Typical High $104.71 | Professional | None | $30.20 | $91.20 | $104.71 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $151.36 Typical High $7,244.36 | Facility | None | $77.62 | $151.36 | $7,244.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $8,511.38 | Professional | None | $120.23 | $151.36 | $8,511.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $173.78 | Facility | None | $112.20 | $114.82 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | None | $85.11 | $85.11 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $120.23 Typical High $154.88 | Facility | None | $112.20 | $120.23 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $125.89 | Professional | None | $79.43 | $120.23 | $125.89 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Facility | None | $60.26 | $60.26 | $63.10 |
United Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $70.79 | Professional | None | $43.65 | $47.86 | $70.79 |
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 $39.81 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $39.81 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $15.85 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $10.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $89.13 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $79.43 | $89.13 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $39.81 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $15.85 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $10.47 |
Where Idaho sits
The same service costs 3.8 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· 3rd of 51
$105
HI $174FL $45.71
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.