How much rates vary
Facilitymedian $98 · 10th to 90th $58 to $162Professionalmedian $87 · 10th to 90th $42 to $129
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 $67.61 Median $87.10 Typical High $87.10 | Professional | None | $67.61 | $87.10 | $87.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $162.18 | Facility | None | $72.44 | $97.72 | $162.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $112.20 | Professional | None | $70.79 | $107.15 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $87.10 Typical High $102.33 | Facility | None | $29.51 | $87.10 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $107.15 | Professional | None | $67.61 | $91.20 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $75.86 Typical High $89.13 | Professional | None | $30.20 | $75.86 | $89.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $6,165.95 | Facility | None | $81.28 | $128.82 | $6,165.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $7,244.36 | Professional | None | $102.33 | $128.82 | $7,244.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $147.91 | Facility | None | $95.50 | $97.72 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $107.15 | Professional | None | $70.79 | $70.79 | $107.15 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $131.83 | Facility | None | $102.33 | $102.33 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $112.20 | Professional | None | $66.07 | $102.33 | $112.20 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $67.61 | Professional | None | $41.69 | $45.71 | $67.61 |
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 $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $13.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $75.86 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $67.61 | $75.86 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $13.49 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
Where Idaho sits
The same service costs 2.6 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· 11th of 51
$87.10
MT $110DE $41.69
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.