How much rates vary
Facilitymedian $107 · 10th to 90th $68 to $178Professionalmedian $98 · 10th to 90th $50 to $141
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 $64.57 Median $97.72 Typical High $97.72 | Professional | None | $64.57 | $97.72 | $97.72 |
BCBS Idaho Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $177.83 | Facility | None | $89.13 | $107.15 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $123.03 | Professional | None | $79.43 | $117.49 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $32.36 Median $97.72 Typical High $112.20 | Facility | None | $32.36 | $97.72 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $117.49 | Professional | None | $74.13 | $97.72 | $117.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $97.72 | Professional | None | $30.20 | $83.18 | $97.72 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $81.28 Median $141.25 Typical High $6,760.83 | Facility | None | $81.28 | $141.25 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $7,943.28 | Professional | None | $112.20 | $141.25 | $7,943.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $162.18 | Facility | None | $104.71 | $107.15 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | None | $79.43 | $79.43 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $144.54 | Facility | None | $104.71 | $112.20 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $123.03 | Professional | None | $74.13 | $112.20 | $123.03 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $74.13 | Professional | None | $46.77 | $50.12 | $74.13 |
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 $37.15 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $15.14 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $9.77 | $9.77 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $74.13 | $83.18 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $15.14 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $9.77 | $9.77 |
Where Idaho sits
The same service costs 4.1 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· 11th of 51
$97.72
HI $209DE $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.