How much rates vary
Facilitymedian $26 · 10th to 90th $16 to $45Professionalmedian $24 · 10th to 90th $12 to $35
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 $18.20 Median $23.99 Typical High $23.99 | Professional | None | $18.20 | $23.99 | $23.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $21.38 Median $26.30 Typical High $44.67 | Facility | None | $21.38 | $26.30 | $44.67 |
BCBS Idaho Setting Professional Modifier None Typical Low $19.50 Median $28.84 Typical High $30.20 | Professional | None | $19.50 | $28.84 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.98 | Facility | None | $15.85 | $15.85 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $23.99 Typical High $27.54 | Facility | None | $8.13 | $23.99 | $27.54 |
Moda Health Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $28.84 | Professional | None | $18.20 | $25.12 | $28.84 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $23.44 Typical High $30.20 | Professional | None | $20.42 | $23.44 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $22.39 Median $34.67 Typical High $1,659.59 | Facility | None | $22.39 | $34.67 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $1,949.84 | Professional | None | $27.54 | $34.67 | $1,949.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $25.70 Median $26.30 Typical High $39.81 | Facility | None | $25.70 | $26.30 | $39.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $28.84 | Professional | None | $19.50 | $19.50 | $28.84 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $35.48 | Facility | None | $27.54 | $27.54 | $35.48 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $30.20 | Professional | None | $18.20 | $27.54 | $30.20 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $18.62 | Professional | None | $11.75 | $12.59 | $18.62 |
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 $9.12 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $9.12 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.75 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.82 | $2.40 | $2.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $18.20 Median $20.42 Typical High $21.38 | Professional | 78 · Unplanned return to OR | $18.20 | $20.42 | $21.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $9.12 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.75 | $3.55 | $3.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.82 | $2.40 | $2.40 |
Where Idaho sits
The same service costs 5.5 times more in Kansas 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· 12th of 51
$23.99
KS $63.10DE $11.48
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.