How much rates vary
Facilitymedian $95 · 10th to 90th $72 to $158Professionalmedian $85 · 10th to 90th $49 to $126
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 $61.66 Median $85.11 Typical High $85.11 | Professional | None | $61.66 | $85.11 | $85.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $158.49 | Facility | None | $77.62 | $95.50 | $158.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $109.65 | Professional | None | $69.18 | $104.71 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $79.43 | Facility | None | $72.44 | $72.44 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $85.11 Typical High $100.00 | Facility | None | $31.62 | $85.11 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $104.71 | Professional | None | $66.07 | $85.11 | $104.71 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $85.11 | Professional | None | $30.20 | $72.44 | $85.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $6,025.60 | Facility | None | $85.11 | $125.89 | $6,025.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $7,079.46 | Professional | None | $100.00 | $125.89 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $144.54 | Facility | None | $93.33 | $95.50 | $144.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $104.71 | Professional | None | $69.18 | $69.18 | $104.71 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Facility | None | $100.00 | $100.00 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $109.65 | Professional | None | $64.57 | $100.00 | $109.65 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $72.44 | Professional | None | $44.67 | $48.98 | $72.44 |
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 $33.11 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $13.18 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.61 | $8.51 | $8.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $74.13 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $64.57 | $74.13 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $13.18 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.61 | $8.51 | $8.51 |
Where Idaho sits
The same service costs 5.0 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
$85.11
HI $257FL $51.29
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.