How much rates vary
Facilitymedian $44 · 10th to 90th $27 to $72Professionalmedian $39 · 10th to 90th $20 to $58
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 $30.20 Median $38.90 Typical High $38.90 | Professional | None | $30.20 | $38.90 | $38.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $35.48 Median $43.65 Typical High $72.44 | Facility | None | $35.48 | $43.65 | $72.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $50.12 | Professional | None | $32.36 | $47.86 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $28.18 | Facility | None | $26.92 | $26.92 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $38.90 Typical High $45.71 | Facility | None | $13.18 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $30.20 Median $40.74 Typical High $47.86 | Professional | None | $30.20 | $40.74 | $47.86 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $39.81 | Professional | None | $30.20 | $34.67 | $39.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $36.31 Median $57.54 Typical High $2,754.23 | Facility | None | $36.31 | $57.54 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $3,235.94 | Professional | None | $47.86 | $57.54 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $43.65 Typical High $66.07 | Facility | None | $42.66 | $43.65 | $66.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | None | $32.36 | $32.36 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $58.88 | Facility | None | $45.71 | $45.71 | $58.88 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $50.12 | Professional | None | $29.51 | $45.71 | $50.12 |
United Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $30.90 | Professional | None | $18.62 | $20.42 | $30.90 |
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 $15.14 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $15.14 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.03 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $4.57 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.02 | $3.89 | $3.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $33.88 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $30.20 | $33.88 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $15.14 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.03 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $4.57 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.02 | $3.89 | $3.89 |
Where Idaho sits
The same service costs 2.5 times more in Montana 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· 13th of 51
$38.90
MT $48.98DE $19.95
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.