How much rates vary
Facilitymedian $87 · 10th to 90th $50 to $145Professionalmedian $74 · 10th to 90th $37 to $112
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 $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $144.54 | Facility | None | $67.61 | $87.10 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $100.00 | Professional | None | $63.10 | $95.50 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Facility | None | $50.12 | $50.12 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $26.30 Median $74.13 Typical High $91.20 | Facility | None | $26.30 | $74.13 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $95.50 | Professional | None | $57.54 | $81.28 | $95.50 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $75.86 | Professional | None | $30.20 | $64.57 | $75.86 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $5,370.32 | Facility | None | $72.44 | $112.20 | $5,370.32 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $6,309.57 | Professional | None | $91.20 | $112.20 | $6,309.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $128.82 | Facility | None | $85.11 | $87.10 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | None | $63.10 | $63.10 | $95.50 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $114.82 | Facility | None | $91.20 | $91.20 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $100.00 | Professional | None | $58.88 | $91.20 | $100.00 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $61.66 | Professional | None | $37.15 | $40.74 | $61.66 |
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 $28.84 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $11.48 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $7.41 | $7.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $58.88 | $66.07 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $11.48 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $7.41 | $7.41 |
Where Idaho sits
The same service costs 2.8 times more in Kansas 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· 13th of 51
$75.86
KS $107DE $38.90
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.