How much rates vary
Facilitymedian $87 · 10th to 90th $58 to $145Professionalmedian $79 · 10th to 90th $41 to $115
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 $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
BCBS Idaho Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $144.54 | Facility | None | $66.07 | $87.10 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $100.00 | Professional | None | $64.57 | $95.50 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
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 $26.30 Median $79.43 Typical High $91.20 | Facility | None | $26.30 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $95.50 | Professional | None | $60.26 | $83.18 | $95.50 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $79.43 | Professional | None | $30.20 | $69.18 | $79.43 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $5,495.41 | Facility | None | $72.44 | $114.82 | $5,495.41 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $6,456.54 | Professional | None | $95.50 | $114.82 | $6,456.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $131.83 | Facility | None | $85.11 | $87.10 | $131.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $95.50 | Professional | None | $64.57 | $64.57 | $95.50 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $117.49 | Facility | None | $91.20 | $91.20 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $100.00 | Professional | None | $58.88 | $91.20 | $100.00 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $61.66 | Professional | None | $37.15 | $40.74 | $61.66 |
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 $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $12.02 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $7.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $67.61 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $60.26 | $67.61 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $12.02 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $7.94 |
Where Idaho sits
The same service costs 2.3 times more in Montana than in Florida. 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
$79.43
MT $97.72FL $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.