How much rates vary
Facilitymedian $93 · 10th to 90th $65 to $155Professionalmedian $83 · 10th to 90th $44 to $123
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 $64.57 Median $83.18 Typical High $83.18 | Professional | None | $64.57 | $83.18 | $83.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $154.88 | Facility | None | $69.18 | $93.33 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $107.15 | Professional | None | $67.61 | $102.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $83.18 Typical High $97.72 | Facility | None | $28.18 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $102.33 | Professional | None | $64.57 | $87.10 | $102.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $83.18 | Professional | None | $30.20 | $72.44 | $83.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $5,888.44 | Facility | None | $77.62 | $123.03 | $5,888.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $6,918.31 | Professional | None | $97.72 | $123.03 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $141.25 | Facility | None | $91.20 | $93.33 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Facility | None | $97.72 | $97.72 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $107.15 | Professional | None | $63.10 | $97.72 | $107.15 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $64.57 | Professional | None | $39.81 | $43.65 | $64.57 |
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 $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $8.32 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $64.57 | $72.44 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $8.32 |
Where Idaho sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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
$83.18
HI $102WV $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.