How much rates vary
Facilitymedian $14 · 10th to 90th $7 to $25Professionalmedian $13 · 10th to 90th $5 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 $9.55 Median $12.30 Typical High $12.30 | Professional | None | $9.55 | $12.30 | $12.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $11.75 Median $14.45 Typical High $24.55 | Facility | None | $11.75 | $14.45 | $24.55 |
BCBS Idaho Setting Professional Modifier None Typical Low $10.47 Median $15.85 Typical High $16.60 | Professional | None | $10.47 | $15.85 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.94 | Facility | None | $7.08 | $7.08 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $12.30 Typical High $15.14 | Facility | None | $3.55 | $12.30 | $15.14 |
Moda Health Setting Professional Modifier None Typical Low $9.55 Median $12.88 Typical High $15.85 | Professional | None | $9.55 | $12.88 | $15.85 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $30.20 | Professional | None | $10.72 | $12.59 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $11.75 Median $18.62 Typical High $912.01 | Facility | None | $11.75 | $18.62 | $912.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $1,047.13 | Professional | None | $15.14 | $18.62 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $14.13 Median $14.45 Typical High $21.38 | Facility | None | $14.13 | $14.45 | $21.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $15.85 | Professional | None | $10.47 | $10.47 | $15.85 |
Select Health Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $19.05 | Facility | None | $15.14 | $15.14 | $19.05 |
Select Health Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $16.60 | Professional | None | $9.77 | $15.14 | $16.60 |
United Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Facility | None | $6.31 | $6.31 | $7.94 |
United Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $8.51 | Professional | None | $5.13 | $5.50 | $8.51 |
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 $4.79 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $4.79 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $1.91 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.45 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.95 | $1.23 | $1.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 78 · Unplanned return to OR | $9.77 | $10.96 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $4.79 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $1.91 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.45 | $1.86 | $1.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.95 | $1.23 | $1.23 |
Where Idaho sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 5th of 51
$12.88
MT $15.49KS $4.37
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.