How much rates vary
Facilitymedian $35 · 10th to 90th $30 to $83Professionalmedian $35 · 10th to 90th $30 to $47
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 $44.67 Median $47.86 Typical High $47.86 | Facility | None | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $39.81 | Professional | None | $31.62 | $39.81 | $39.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $29.51 Median $32.36 Typical High $57.54 | Facility | None | $29.51 | $32.36 | $57.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $46.77 | Professional | None | $29.51 | $33.11 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $81.28 | Facility | None | $39.81 | $39.81 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $151.36 | Facility | None | $39.81 | $44.67 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $44.67 | Professional | None | $31.62 | $39.81 | $44.67 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $35.48 Median $40.74 Typical High $53.70 | Facility | None | $35.48 | $40.74 | $53.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | None | $39.81 | $40.74 | $42.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.90 Median $83.18 Typical High $141.25 | Facility | None | $30.90 | $83.18 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | None | $35.48 | $38.02 | $38.02 |
Select Health Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $66.07 | Facility | None | $31.62 | $31.62 | $66.07 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | None | $31.62 | $31.62 | $32.36 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | None | $35.48 | $35.48 | $38.02 |
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 $16.22 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $16.22 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $3.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $23.44 Median $24.55 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $23.44 | $24.55 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.76 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.89 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.47 | $4.47 |
Where Idaho sits
The same service costs 1.7 times more in Hawaii 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· 24th of 51
$35.48
HI $54.95KY $31.62
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.