How much rates vary
Facilitymedian $24 · 10th to 90th $19 to $871Professionalmedian $25 · 10th to 90th $10 to $38
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 Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $31.62 Typical High $31.62 | Professional | None | $13.18 | $31.62 | $31.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.60 Median $22.39 Typical High $38.02 | Facility | None | $16.60 | $22.39 | $38.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $26.30 | Professional | None | $16.60 | $25.12 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $23.99 Typical High $45.71 | Facility | None | $15.14 | $23.99 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $25.12 Typical High $31.62 | Professional | None | $13.18 | $25.12 | $31.62 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | None | $16.98 | $19.95 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $29.51 Median $870.96 Typical High $1,412.54 | Facility | None | $29.51 | $870.96 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $1,659.59 | Professional | None | $25.12 | $29.51 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $25.12 | Professional | None | $16.60 | $16.60 | $25.12 |
Select Health Setting Facility Modifier None Typical Low $23.44 Median $23.99 Typical High $28.18 | Facility | None | $23.44 | $23.99 | $28.18 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $54.95 | Professional | None | $23.99 | $26.30 | $54.95 |
United Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $17.78 | Professional | None | $7.76 | $9.77 | $17.78 |
11 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 $6.61 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $6.61 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $2.63 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $10.00 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $2.00 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.32 | $3.16 | $3.16 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $15.49 Median $17.38 Typical High $18.20 | Professional | 78 · Unplanned return to OR | $15.49 | $17.38 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $6.61 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $2.63 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $10.00 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $2.00 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.32 | $3.16 | $3.16 |
Where Idaho sits
The same service costs 2.9 times more in Rhode Island than in New York. 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· 3rd of 51
$25.12
RI $26.92NY $9.33
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.