How much rates vary
Facilitymedian $110 · 10th to 90th $78 to $178Professionalmedian $93 · 10th to 90th $51 to $141
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 $72.44 Median $93.33 Typical High $93.33 | Professional | None | $72.44 | $93.33 | $93.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $177.83 | Facility | None | $89.13 | $109.65 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $125.89 | Professional | None | $79.43 | $120.23 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $93.33 Typical High $112.20 | Facility | None | $33.11 | $93.33 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $120.23 | Professional | None | $72.44 | $102.33 | $120.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $81.28 Typical High $95.50 | Professional | None | $30.20 | $81.28 | $95.50 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $6,760.83 | Facility | None | $91.20 | $141.25 | $6,760.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $7,943.28 | Professional | None | $120.23 | $141.25 | $7,943.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $162.18 | Facility | None | $104.71 | $109.65 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | None | $79.43 | $79.43 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $144.54 | Facility | None | $112.20 | $112.20 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $123.03 | Professional | None | $74.13 | $112.20 | $123.03 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $77.62 | Professional | None | $46.77 | $51.29 | $77.62 |
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 $36.31 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $14.45 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $10.72 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.24 | $9.33 | $9.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $74.13 | $83.18 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $36.31 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $14.45 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $10.72 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.24 | $9.33 | $9.33 |
Where Idaho sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 11th of 51
$95.50
MT $120VA $61.66
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.