How much rates vary
Facilitymedian $126 · 10th to 90th $60 to $209Professionalmedian $107 · 10th to 90th $44 to $162
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 $83.18 Median $107.15 Typical High $107.15 | Professional | None | $83.18 | $107.15 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $208.93 | Facility | None | $102.33 | $125.89 | $208.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $144.54 | Professional | None | $91.20 | $138.04 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Facility | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | None | $43.65 | $43.65 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $107.15 Typical High $131.83 | Facility | None | $30.90 | $107.15 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $138.04 | Professional | None | $83.18 | $117.49 | $138.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $93.33 Typical High $112.20 | Professional | None | $30.20 | $93.33 | $112.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $85.11 Median $162.18 Typical High $7,943.28 | Facility | None | $85.11 | $162.18 | $7,943.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $9,120.11 | Professional | None | $131.83 | $162.18 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $186.21 | Facility | None | $123.03 | $125.89 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $169.82 | Facility | None | $120.23 | $131.83 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $138.04 | Professional | None | $85.11 | $131.83 | $138.04 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
United Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $74.13 | Professional | None | $44.67 | $47.86 | $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 $41.69 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $10.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $95.50 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $85.11 | $95.50 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $41.69 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.60 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.32 | $10.72 | $10.72 |
Where Idaho sits
The same service costs 3.6 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
$107
HI $158DE $43.65
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.