How much rates vary
Facilitymedian $35 · 10th to 90th $27 to $68Professionalmedian $28 · 10th to 90th $24 to $35
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 $34.67 Median $36.31 Typical High $45.71 | Facility | None | $34.67 | $36.31 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | None | $24.55 | $30.90 | $30.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $28.84 Median $38.90 Typical High $67.61 | Facility | None | $28.84 | $38.90 | $67.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $70.79 | Professional | None | $26.92 | $29.51 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $61.66 | Facility | None | $28.18 | $28.18 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Moda Health Setting Facility Modifier None Typical Low $26.30 Median $30.90 Typical High $169.82 | Facility | None | $26.30 | $30.90 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $30.90 | Professional | None | $24.55 | $29.51 | $30.90 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | None | $20.89 | $24.55 | $24.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $26.92 Median $27.54 Typical High $36.31 | Facility | None | $26.92 | $27.54 | $36.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $30.90 | Professional | None | $27.54 | $28.18 | $30.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $81.28 | Facility | None | $29.51 | $43.65 | $81.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $30.90 | Professional | None | $26.92 | $29.51 | $30.90 |
Select Health Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $50.12 | Facility | None | $24.55 | $24.55 | $50.12 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $33.88 | Professional | None | $23.99 | $24.55 | $33.88 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | None | $23.99 | $23.99 | $25.12 |
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 $12.30 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $12.30 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.01 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $3.72 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.45 | $3.09 | $3.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.05 Median $19.05 Typical High $47.86 | Professional | 78 · Unplanned return to OR | $19.05 | $19.05 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $12.88 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.13 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.89 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.57 | $2.95 | $2.95 |
Where Idaho sits
The same service costs 2.8 times more in Wyoming than in North Carolina. 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· 8th of 51
$28.18
WY $61.66NC $22.39
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.