How much rates vary
Facilitymedian $37 · 10th to 90th $25 to $56Professionalmedian $27 · 10th to 90th $17 to $33
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 $24.55 Median $24.55 Typical High $26.92 | Professional | None | $24.55 | $24.55 | $26.92 |
BCBS Idaho Setting Facility Modifier None Typical Low $33.88 Median $40.74 Typical High $60.26 | Facility | None | $33.88 | $40.74 | $60.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | None | $31.62 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Facility | None | $27.54 | $27.54 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $24.55 Typical High $26.92 | Facility | None | $13.18 | $24.55 | $26.92 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | None | $24.55 | $24.55 | $26.92 |
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 $26.92 Median $30.90 Typical High $44.67 | Facility | None | $26.92 | $30.90 | $44.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $51.29 | Professional | None | $26.92 | $30.90 | $51.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $64.57 | Facility | None | $39.81 | $42.66 | $64.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Select Health Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $25.70 | Professional | None | $16.22 | $17.38 | $25.70 |
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 $12.02 Median $12.02 Typical High $13.49 | Professional | 52 · Reduced service | $12.02 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.07 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $22.39 Typical High $23.44 | Professional | 78 · Unplanned return to OR | $19.95 | $22.39 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 52 · Reduced service | $12.02 | $12.02 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.07 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.69 |
Where Idaho sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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
$26.92
WY $75.86CO $17.38
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.