How much rates vary
Facilitymedian $19 · 10th to 90th $11 to $30Professionalmedian $14 · 10th to 90th $8 to $22
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 Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $60.26 | Facility | None | $13.49 | $13.49 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.88 | Professional | None | $11.22 | $11.22 | $12.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $15.49 Median $21.38 Typical High $29.51 | Facility | None | $15.49 | $21.38 | $29.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | None | $18.62 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $22.39 | Facility | None | $20.89 | $20.89 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $11.22 Typical High $23.44 | Facility | None | $6.17 | $11.22 | $23.44 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $22.91 | Professional | None | $11.22 | $11.22 | $22.91 |
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 $12.59 Median $14.13 Typical High $20.42 | Facility | None | $12.59 | $14.13 | $20.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $23.99 | Professional | None | $12.59 | $14.13 | $23.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $18.62 Median $19.95 Typical High $29.51 | Facility | None | $18.62 | $19.95 | $29.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $87.10 | Facility | None | $53.70 | $61.66 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $7.59 Median $7.94 Typical High $11.75 | Professional | None | $7.59 | $7.94 | $11.75 |
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 $5.62 Median $5.62 Typical High $6.31 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.51 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.86 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11.75 Median $13.18 Typical High $13.80 | Professional | 78 · Unplanned return to OR | $11.75 | $13.18 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.62 Typical High $6.31 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.51 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.86 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.26 |
Where Idaho sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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
$14.45
WY $53.70NC $8.71
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.