How much rates vary
Facilitymedian $34 · 10th to 90th $23 to $83Professionalmedian $25 · 10th to 90th $21 to $37
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 $21.38 Median $26.30 Typical High $26.30 | Professional | None | $21.38 | $26.30 | $26.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $83.18 | Facility | None | $24.55 | $38.02 | $83.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $33.88 | Professional | None | $22.91 | $23.44 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $53.70 | Facility | None | $29.51 | $29.51 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $26.30 Typical High $37.15 | Facility | None | $20.89 | $26.30 | $37.15 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $31.62 Typical High $37.15 | Professional | None | $20.89 | $31.62 | $37.15 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $22.91 | Professional | None | $19.50 | $22.91 | $22.91 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $22.91 Median $33.88 Typical High $44.67 | Facility | None | $22.91 | $33.88 | $44.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $35.48 | Professional | None | $26.30 | $33.88 | $35.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $33.88 Median $48.98 Typical High $141.25 | Facility | None | $33.88 | $48.98 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | None | $22.91 | $25.12 | $25.12 |
Select Health Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $43.65 | Facility | None | $20.89 | $20.89 | $43.65 |
Select Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | None | $20.89 | $20.89 | $21.88 |
United Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | None | $29.51 | $29.51 | $31.62 |
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 $10.72 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $10.72 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $4.27 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.16 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.14 | $2.63 | $2.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $15.49 Median $16.22 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $15.49 | $16.22 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $6.46 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.90 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.24 | $3.72 | $3.72 |
Where Idaho sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 20th of 51
$26.30
WY $79.43KY $20.89
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.