How much rates vary
Facilitymedian $120 · 10th to 90th $71 to $200Professionalmedian $110 · 10th to 90th $51 to $158
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 $83.18 Median $109.65 Typical High $109.65 | Professional | None | $83.18 | $109.65 | $109.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $199.53 | Facility | None | $91.20 | $120.23 | $199.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $138.04 | Professional | None | $89.13 | $131.83 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Facility | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $109.65 Typical High $125.89 | Facility | None | $36.31 | $109.65 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $131.83 | Professional | None | $83.18 | $114.82 | $131.83 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $95.50 Typical High $109.65 | Professional | None | $30.20 | $95.50 | $109.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $7,585.78 | Facility | None | $102.33 | $158.49 | $7,585.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $8,912.51 | Professional | None | $131.83 | $158.49 | $8,912.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $117.49 Median $120.23 Typical High $181.97 | Facility | None | $117.49 | $120.23 | $181.97 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | None | $89.13 | $89.13 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Facility | None | $125.89 | $125.89 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $138.04 | Professional | None | $83.18 | $125.89 | $138.04 |
United Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $85.11 | Professional | None | $51.29 | $56.23 | $85.11 |
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 $41.69 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $10.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $93.33 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $83.18 | $93.33 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $41.69 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $10.96 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii 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· 10th of 51
$110
HI $132DE $51.29
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.