How much rates vary
Facilitymedian $102 · 10th to 90th $65 to $170Professionalmedian $93 · 10th to 90th $45 to $135
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 $63.10 Median $93.33 Typical High $93.33 | Professional | None | $63.10 | $93.33 | $93.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $91.20 Median $102.33 Typical High $169.82 | Facility | None | $91.20 | $102.33 | $169.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $117.49 | Professional | None | $75.86 | $112.20 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Facility | None | $61.66 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $107.15 | Facility | None | $70.79 | $93.33 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $112.20 | Professional | None | $70.79 | $93.33 | $112.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $91.20 | Professional | None | $30.20 | $77.62 | $91.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $6,456.54 | Facility | None | $107.15 | $134.90 | $6,456.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $7,585.78 | Professional | None | $107.15 | $134.90 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $154.88 | Facility | None | $100.00 | $102.33 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $112.20 | Professional | None | $75.86 | $75.86 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $109.65 | Facility | None | $97.72 | $107.15 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $117.49 | Professional | None | $69.18 | $107.15 | $117.49 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | None | $44.67 | $47.86 | $58.88 |
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 $35.48 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $35.48 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.08 | $9.33 | $9.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $70.79 | $79.43 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $35.48 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.08 | $9.33 | $9.33 |
Where Idaho sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 9th of 51
$93.33
WI $100NJ $47.86
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.