How much rates vary
Facilitymedian $23 · 10th to 90th $15 to $39Professionalmedian $21 · 10th to 90th $12 to $31
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 $15.49 Median $20.42 Typical High $20.42 | Professional | None | $15.49 | $20.42 | $20.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $20.42 Median $23.44 Typical High $38.90 | Facility | None | $20.42 | $23.44 | $38.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $17.38 Median $25.70 Typical High $26.92 | Professional | None | $17.38 | $25.70 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $18.20 | Facility | None | $16.22 | $16.22 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $7.59 Median $20.42 Typical High $24.55 | Facility | None | $7.59 | $20.42 | $24.55 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $20.42 Typical High $25.70 | Professional | None | $15.49 | $20.42 | $25.70 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $30.20 | Professional | None | $17.78 | $20.89 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $18.62 Median $30.90 Typical High $1,479.11 | Facility | None | $18.62 | $30.90 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $1,737.80 | Professional | None | $24.55 | $30.90 | $1,737.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $35.48 | Facility | None | $22.91 | $23.44 | $35.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | None | $17.38 | $17.38 | $25.70 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $24.55 Typical High $31.62 | Facility | None | $23.99 | $24.55 | $31.62 |
Select Health Setting Professional Modifier None Typical Low $15.85 Median $24.55 Typical High $26.92 | Professional | None | $15.85 | $24.55 | $26.92 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $17.78 | Professional | None | $10.72 | $11.75 | $17.78 |
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 $7.76 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $7.76 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $3.16 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.34 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.58 | $2.04 | $2.04 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.22 Median $18.20 Typical High $19.05 | Professional | 78 · Unplanned return to OR | $16.22 | $18.20 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $7.76 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $3.16 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $2.34 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.58 | $2.04 | $2.04 |
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· 15th of 51
$20.89
HI $35.48DE $12.02
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.