How much rates vary
Facilitymedian $170 · 10th to 90th $56 to $257Professionalmedian $110 · 10th to 90th $42 to $151
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 $109.65 Median $109.65 Typical High $123.03 | Professional | None | $109.65 | $109.65 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $181.97 Typical High $269.15 | Facility | None | $154.88 | $181.97 | $269.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | None | $144.54 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $109.65 Typical High $123.03 | Facility | None | $60.26 | $109.65 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | None | $109.65 | $109.65 | $123.03 |
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 $123.03 Median $138.04 Typical High $199.53 | Facility | None | $123.03 | $138.04 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $234.42 | Professional | None | $123.03 | $138.04 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $288.40 | Facility | None | $181.97 | $194.98 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $114.82 | Professional | None | $74.13 | $77.62 | $114.82 |
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 $54.95 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $54.95 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $21.88 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
Where Idaho sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 14th of 51
$123
ND $295DE $60.26
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.