How much rates vary
Facilitymedian $74 · 10th to 90th $51 to $123Professionalmedian $66 · 10th to 90th $38 to $98
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 $51.29 Median $66.07 Typical High $66.07 | Professional | None | $51.29 | $66.07 | $66.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $54.95 Median $74.13 Typical High $123.03 | Facility | None | $54.95 | $74.13 | $123.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $85.11 | Professional | None | $54.95 | $81.28 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | None | $54.95 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $66.07 Typical High $77.62 | Facility | None | $24.55 | $66.07 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $81.28 | Professional | None | $51.29 | $69.18 | $81.28 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $67.61 | Professional | None | $30.20 | $58.88 | $67.61 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $61.66 Median $97.72 Typical High $4,677.35 | Facility | None | $61.66 | $97.72 | $4,677.35 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $5,495.41 | Professional | None | $77.62 | $97.72 | $5,495.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $112.20 | Facility | None | $72.44 | $74.13 | $112.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Professional | None | $54.95 | $54.95 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $85.11 | Professional | None | $50.12 | $77.62 | $85.11 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $56.23 | Professional | None | $35.48 | $38.02 | $56.23 |
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 $25.70 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $6.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $51.29 | $57.54 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $25.70 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $6.61 |
Where Idaho sits
The same service costs 3.5 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· 15th of 51
$66.07
HI $141WV $39.81
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.