How much rates vary
Facilitymedian $251 · 10th to 90th $145 to $427Professionalmedian $214 · 10th to 90th $105 to $324
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 $165.96 Median $213.80 Typical High $213.80 | Professional | None | $165.96 | $213.80 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $426.58 | Facility | None | $204.17 | $251.19 | $426.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $288.40 | Professional | None | $181.97 | $275.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $186.21 | Facility | None | $173.78 | $173.78 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $213.80 Typical High $263.03 | Facility | None | $67.61 | $213.80 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $275.42 | Professional | None | $165.96 | $234.42 | $275.42 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $223.87 | Professional | None | $30.20 | $190.55 | $223.87 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $190.55 Median $323.59 Typical High $15,848.93 | Facility | None | $190.55 | $323.59 | $15,848.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $18,620.87 | Professional | None | $263.03 | $323.59 | $18,620.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $371.54 | Facility | None | $245.47 | $251.19 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $275.42 | Professional | None | $181.97 | $181.97 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $338.84 | Facility | None | $239.88 | $263.03 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $288.40 | Professional | None | $169.82 | $263.03 | $288.40 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $158.49 | Professional | None | $95.50 | $104.71 | $158.49 |
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 $83.18 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $21.38 | $21.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $33.11 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $21.38 | $21.38 |
Where Idaho sits
The same service costs 2.0 times more in Wisconsin 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· 10th of 51
$219
WI $257DE $129
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.