How much rates vary
Facilitymedian $68 · 10th to 90th $44 to $112Professionalmedian $62 · 10th to 90th $32 to $89
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 $41.69 Median $61.66 Typical High $61.66 | Professional | None | $41.69 | $61.66 | $61.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $112.20 | Facility | None | $53.70 | $67.61 | $112.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $77.62 | Professional | None | $50.12 | $74.13 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $51.29 | Facility | None | $46.77 | $46.77 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $61.66 Typical High $70.79 | Facility | None | $20.89 | $61.66 | $70.79 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $74.13 | Professional | None | $46.77 | $61.66 | $74.13 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $51.29 Typical High $60.26 | Professional | None | $30.20 | $51.29 | $60.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $52.48 Median $89.13 Typical High $4,265.80 | Facility | None | $52.48 | $89.13 | $4,265.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $5,011.87 | Professional | None | $70.79 | $89.13 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $102.33 | Facility | None | $66.07 | $67.61 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | None | $50.12 | $50.12 | $74.13 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $91.20 | Facility | None | $66.07 | $70.79 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $77.62 | Professional | None | $45.71 | $70.79 | $77.62 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $47.86 | Professional | None | $30.20 | $32.36 | $47.86 |
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 $23.44 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $23.44 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $7.08 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $6.17 | $6.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $52.48 Typical High $54.95 | Professional | 78 · Unplanned return to OR | $46.77 | $52.48 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $23.44 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $7.08 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $6.17 | $6.17 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii 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· 10th of 51
$61.66
HI $105FL $33.88
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.