How much rates vary
Facilitymedian $56 · 10th to 90th $33 to $93Professionalmedian $51 · 10th to 90th $25 to $74
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 $38.90 Median $51.29 Typical High $51.29 | Professional | None | $38.90 | $51.29 | $51.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $93.33 | Facility | None | $45.71 | $57.54 | $93.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $66.07 | Professional | None | $41.69 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Facility | None | $33.11 | $33.11 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $51.29 Typical High $58.88 | Facility | None | $17.38 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $63.10 | Professional | None | $38.90 | $53.70 | $63.10 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $51.29 | Professional | None | $30.20 | $44.67 | $51.29 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $3,548.13 | Facility | None | $47.86 | $74.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $4,168.69 | Professional | None | $58.88 | $74.13 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $85.11 | Facility | None | $54.95 | $57.54 | $85.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None | $41.69 | $41.69 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $75.86 | Facility | None | $58.88 | $58.88 | $75.86 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $64.57 | Professional | None | $38.90 | $58.88 | $64.57 |
United Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $39.81 | Professional | None | $23.99 | $26.92 | $39.81 |
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 $19.50 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $19.50 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $7.94 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.89 | $5.13 | $5.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $38.90 | $43.65 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $19.50 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $7.94 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.89 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.89 | $5.13 | $5.13 |
Where Idaho sits
The same service costs 2.8 times more in Kansas 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
$51.29
KS $69.18DE $24.55
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.