How much rates vary
Facilitymedian $85 · 10th to 90th $59 to $145Professionalmedian $78 · 10th to 90th $44 to $112
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 $58.88 Median $77.62 Typical High $77.62 | Professional | None | $58.88 | $77.62 | $77.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $144.54 | Facility | None | $69.18 | $85.11 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $97.72 | Professional | None | $63.10 | $93.33 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Facility | None | $66.07 | $66.07 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $77.62 Typical High $89.13 | Facility | None | $28.18 | $77.62 | $89.13 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $93.33 | Professional | None | $58.88 | $77.62 | $93.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $77.62 | Professional | None | $30.20 | $67.61 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $112.20 Typical High $5,370.32 | Facility | None | $70.79 | $112.20 | $5,370.32 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $6,309.57 | Professional | None | $89.13 | $112.20 | $6,309.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $128.82 | Facility | None | $83.18 | $85.11 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None | $63.10 | $63.10 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $114.82 | Facility | None | $89.13 | $89.13 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $97.72 | Professional | None | $58.88 | $89.13 | $97.72 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Facility | None | $58.88 | $58.88 | $60.26 |
United Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $66.07 | Professional | None | $40.74 | $43.65 | $66.07 |
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 $29.51 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $11.75 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $7.76 | $7.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $58.88 | $66.07 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $11.75 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $7.76 | $7.76 |
Where Idaho sits
The same service costs 3.6 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· 12th of 51
$77.62
HI $174FL $47.86
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.