How much rates vary
Facilitymedian $102 · 10th to 90th $54 to $170Professionalmedian $91 · 10th to 90th $39 to $132
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 $58.88 Median $91.20 Typical High $91.20 | Professional | None | $58.88 | $91.20 | $91.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $169.82 | Facility | None | $89.13 | $102.33 | $169.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $117.49 | Professional | None | $74.13 | $112.20 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Facility | None | $53.70 | $53.70 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $107.15 | Facility | None | $63.10 | $91.20 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $91.20 | Professional | None | $63.10 | $91.20 | $91.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $6,456.54 | Facility | None | $107.15 | $131.83 | $6,456.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $7,413.10 | Professional | None | $107.15 | $131.83 | $7,413.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $151.36 | Facility | None | $100.00 | $102.33 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | None | $74.13 | $74.13 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $109.65 | Facility | None | $87.10 | $107.15 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $114.82 | Professional | None | $69.18 | $107.15 | $114.82 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $52.48 | Professional | None | $40.74 | $42.66 | $52.48 |
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 $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $14.13 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.08 | $9.12 | $9.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $77.62 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $69.18 | $77.62 | $81.28 |
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 $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $14.13 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.08 | $9.12 | $9.12 |
Where Idaho sits
The same service costs 3.3 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· 7th of 51
$91.20
HI $135DE $40.74
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.