How much rates vary
Facilitymedian $234 · 10th to 90th $155 to $398Professionalmedian $204 · 10th to 90th $112 to $309
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 $154.88 Median $204.17 Typical High $204.17 | Professional | None | $154.88 | $204.17 | $204.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $398.11 | Facility | None | $190.55 | $234.42 | $398.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $269.15 | Professional | None | $169.82 | $257.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $204.17 Typical High $245.47 | Facility | None | $72.44 | $204.17 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $257.04 | Professional | None | $154.88 | $218.78 | $257.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $177.83 Typical High $208.93 | Professional | None | $30.20 | $177.83 | $208.93 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $14,791.08 | Facility | None | $194.98 | $309.03 | $14,791.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $17,378.01 | Professional | None | $245.47 | $309.03 | $17,378.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $354.81 | Facility | None | $229.09 | $234.42 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Professional | None | $169.82 | $169.82 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $316.23 | Facility | None | $245.47 | $245.47 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $269.15 | Professional | None | $158.49 | $245.47 | $269.15 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $173.78 | Professional | None | $102.33 | $112.20 | $173.78 |
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 $77.62 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $20.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $77.62 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $20.42 |
Where Idaho sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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
$209
HI $282NJ $117
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.