How much rates vary
Facilitymedian $200 · 10th to 90th $138 to $331Professionalmedian $178 · 10th to 90th $93 to $263
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 $123.03 Median $177.83 Typical High $177.83 | Professional | None | $123.03 | $177.83 | $177.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $199.53 Typical High $331.13 | Facility | None | $147.91 | $199.53 | $331.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $229.09 | Professional | None | $147.91 | $218.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $177.83 Typical High $208.93 | Facility | None | $60.26 | $177.83 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | None | $138.04 | $177.83 | $218.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $158.49 Typical High $181.97 | Professional | None | $30.20 | $158.49 | $181.97 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $12,589.25 | Facility | None | $165.96 | $263.03 | $12,589.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $14,791.08 | Professional | None | $208.93 | $263.03 | $14,791.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $302.00 | Facility | None | $194.98 | $199.53 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | None | $147.91 | $147.91 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Facility | None | $208.93 | $208.93 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $229.09 | Professional | None | $134.90 | $208.93 | $229.09 |
United Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $138.04 | Professional | None | $87.10 | $93.33 | $138.04 |
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 $69.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
Where Idaho sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 11th of 51
$178
WY $209NJ $102
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.