How much rates vary
Facilitymedian $151 · 10th to 90th $98 to $251Professionalmedian $129 · 10th to 90th $72 to $195
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 $100.00 Median $128.82 Typical High $128.82 | Professional | None | $100.00 | $128.82 | $128.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $251.19 | Facility | None | $123.03 | $151.36 | $251.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $173.78 | Professional | None | $109.65 | $165.96 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $128.82 Typical High $154.88 | Facility | None | $48.98 | $128.82 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $165.96 | Professional | None | $100.00 | $141.25 | $165.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $112.20 Typical High $131.83 | Professional | None | $30.20 | $112.20 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $134.90 Median $194.98 Typical High $9,332.54 | Facility | None | $134.90 | $194.98 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $10,964.78 | Professional | None | $154.88 | $194.98 | $10,964.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $223.87 | Facility | None | $144.54 | $151.36 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | None | $109.65 | $109.65 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Facility | None | $154.88 | $154.88 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $169.82 | Professional | None | $102.33 | $154.88 | $169.82 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | None | $60.26 | $60.26 | $75.86 |
United Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $117.49 | Professional | None | $70.79 | $75.86 | $117.49 |
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 $50.12 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $12.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $102.33 | $114.82 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $12.88 |
Where Idaho sits
The same service costs 2.9 times more in Montana than in Florida. 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· 13th of 51
$132
MT $209FL $72.44
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.