How much rates vary
Facilitymedian $22 · 10th to 90th $13 to $37Professionalmedian $19 · 10th to 90th $10 to $30
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 $14.45 Median $18.62 Typical High $18.62 | Professional | None | $14.45 | $18.62 | $18.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $18.62 Median $21.88 Typical High $37.15 | Facility | None | $18.62 | $21.88 | $37.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $15.85 Median $23.99 Typical High $25.12 | Professional | None | $15.85 | $23.99 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.85 | Facility | None | $14.45 | $14.45 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Moda Health Setting Facility Modifier None Typical Low $6.03 Median $18.62 Typical High $22.91 | Facility | None | $6.03 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $23.99 | Professional | None | $14.45 | $20.42 | $23.99 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $30.20 | Professional | None | $16.22 | $19.05 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $15.14 Median $28.18 Typical High $1,348.96 | Facility | None | $15.14 | $28.18 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $22.91 Median $28.18 Typical High $1,584.89 | Professional | None | $22.91 | $28.18 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $21.38 Median $21.88 Typical High $32.36 | Facility | None | $21.38 | $21.88 | $32.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $23.99 | Professional | None | $15.85 | $15.85 | $23.99 |
Select Health Setting Facility Modifier None Typical Low $20.89 Median $22.91 Typical High $28.84 | Facility | None | $20.89 | $22.91 | $28.84 |
Select Health Setting Professional Modifier None Typical Low $14.79 Median $22.91 Typical High $25.12 | Professional | None | $14.79 | $22.91 | $25.12 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $14.45 | Professional | None | $8.71 | $9.33 | $14.45 |
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 $7.24 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $7.24 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $2.88 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.19 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.45 | $1.86 | $1.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.79 Median $16.60 Typical High $17.38 | Professional | 78 · Unplanned return to OR | $14.79 | $16.60 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $7.24 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $2.88 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.19 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.45 | $1.86 | $1.86 |
Where Idaho sits
The same service costs 3.0 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· 6th of 51
$19.50
HI $31.62DE $10.47
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.