How much rates vary
Facilitymedian $40 · 10th to 90th $26 to $62Professionalmedian $29 · 10th to 90th $19 to $35
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 $25.70 Median $25.70 Typical High $28.84 | Professional | None | $25.70 | $25.70 | $28.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $36.31 Median $43.65 Typical High $63.10 | Facility | None | $36.31 | $43.65 | $63.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | None | $33.88 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Facility | None | $28.84 | $28.84 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $25.70 Typical High $28.84 | Facility | None | $14.13 | $25.70 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | None | $25.70 | $25.70 | $28.84 |
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 $28.84 Median $32.36 Typical High $46.77 | Facility | None | $28.84 | $32.36 | $46.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $54.95 | Professional | None | $28.84 | $32.36 | $54.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $67.61 | Facility | None | $42.66 | $45.71 | $67.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $27.54 | Professional | None | $17.38 | $18.62 | $27.54 |
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 $12.88 Median $12.88 Typical High $14.45 | Professional | 52 · Reduced service | $12.88 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.75 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 78 · Unplanned return to OR | $21.38 | $23.99 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 52 · Reduced service | $12.88 | $12.88 | $14.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.75 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.88 |
Where Idaho sits
The same service costs 4.1 times more in Wyoming than in Utah. 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
$28.84
WY $75.86UT $18.62
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.