How much rates vary
Facilitymedian $49 · 10th to 90th $30 to $72Professionalmedian $32 · 10th to 90th $22 to $44
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 $31.62 Median $31.62 Typical High $35.48 | Professional | None | $31.62 | $31.62 | $35.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $77.62 | Facility | None | $44.67 | $52.48 | $77.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | None | $41.69 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Facility | None | $30.20 | $30.20 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $31.62 Typical High $35.48 | Facility | None | $17.38 | $31.62 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | None | $31.62 | $31.62 | $35.48 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $57.54 | Facility | None | $35.48 | $39.81 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $67.61 | Professional | None | $35.48 | $39.81 | $67.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $52.48 Median $56.23 Typical High $83.18 | Facility | None | $52.48 | $56.23 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $33.11 | Professional | None | $21.38 | $22.39 | $33.11 |
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 $15.85 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.08 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.25 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.30 Median $28.84 Typical High $30.90 | Professional | 78 · Unplanned return to OR | $26.30 | $28.84 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $15.85 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.08 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.25 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.55 |
Where Idaho sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 18th of 51
$35.48
KS $135HI $20.89
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.