How much rates vary
Facilitymedian $135 · 10th to 90th $66 to $229Professionalmedian $123 · 10th to 90th $49 to $178
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 $81.28 Median $123.03 Typical High $123.03 | Professional | None | $81.28 | $123.03 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $229.09 | Facility | None | $109.65 | $134.90 | $229.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $154.88 | Professional | None | $100.00 | $147.91 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $123.03 Typical High $141.25 | Facility | None | $33.88 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $147.91 | Professional | None | $93.33 | $123.03 | $147.91 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $102.33 Typical High $120.23 | Professional | None | $30.20 | $102.33 | $120.23 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $85.11 Median $177.83 Typical High $8,511.38 | Facility | None | $85.11 | $177.83 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $10,000.00 | Professional | None | $141.25 | $177.83 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $204.17 | Facility | None | $131.83 | $134.90 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | None | $100.00 | $100.00 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $141.25 Typical High $181.97 | Facility | None | $131.83 | $141.25 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | None | $93.33 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $69.18 | Facility | None | $61.66 | $61.66 | $69.18 |
United Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $77.62 | Professional | None | $47.86 | $52.48 | $77.62 |
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 $45.71 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $18.20 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $13.80 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $12.30 | $12.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $46.77 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $14.13 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $12.30 |
Where Idaho sits
The same service costs 3.5 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· 4th of 51
$123
HI $174FL $48.98
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.