How much rates vary
Facilitymedian $102 · 10th to 90th $51 to $170Professionalmedian $87 · 10th to 90th $38 to $135
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 $67.61 Median $87.10 Typical High $87.10 | Professional | None | $67.61 | $87.10 | $87.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $169.82 | Facility | None | $83.18 | $102.33 | $169.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $117.49 | Professional | None | $74.13 | $112.20 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $87.10 Typical High $107.15 | Facility | None | $25.70 | $87.10 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $112.20 | Professional | None | $67.61 | $95.50 | $112.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $91.20 | Professional | None | $30.20 | $77.62 | $91.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $134.90 Typical High $6,456.54 | Facility | None | $64.57 | $134.90 | $6,456.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $7,585.78 | Professional | None | $107.15 | $134.90 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $154.88 | Facility | None | $100.00 | $102.33 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | None | $74.13 | $74.13 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $138.04 | Facility | None | $97.72 | $107.15 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $107.15 | Professional | None | $69.18 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
United Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $61.66 | Professional | None | $37.15 | $39.81 | $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 $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $77.62 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $69.18 | $77.62 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
Where Idaho sits
The same service costs 4.9 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· 4th of 51
$87.10
HI $186DE $38.02
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.