How much rates vary
Facilitymedian $182 · 10th to 90th $107 to $302Professionalmedian $166 · 10th to 90th $79 to $240
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 $125.89 Median $165.96 Typical High $165.96 | Professional | None | $125.89 | $165.96 | $165.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $302.00 | Facility | None | $138.04 | $181.97 | $302.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $213.80 | Professional | None | $134.90 | $199.53 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $117.49 | Facility | None | $107.15 | $107.15 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $165.96 Typical High $190.55 | Facility | None | $54.95 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $199.53 | Professional | None | $125.89 | $173.78 | $199.53 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $144.54 Typical High $165.96 | Professional | None | $30.20 | $144.54 | $165.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $11,481.54 | Facility | None | $154.88 | $239.88 | $11,481.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $13,489.63 | Professional | None | $190.55 | $239.88 | $13,489.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $275.42 | Facility | None | $177.83 | $181.97 | $275.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | None | $134.90 | $134.90 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $208.93 | Professional | None | $125.89 | $190.55 | $208.93 |
United Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $128.82 | Professional | None | $77.62 | $85.11 | $128.82 |
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 $63.10 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $16.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $16.60 |
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· 12th of 51
$166
MT $204DE $79.43
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.