How much rates vary
Facilitymedian $16 · 10th to 90th $14 to $55Professionalmedian $20 · 10th to 90th $14 to $25
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 $18.62 Median $22.91 Typical High $22.91 | Professional | None | $18.62 | $22.91 | $22.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $14.45 Median $15.85 Typical High $33.11 | Facility | None | $14.45 | $15.85 | $33.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $22.91 | Professional | None | $14.45 | $16.22 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $46.77 | Facility | None | $19.50 | $19.50 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $22.91 Typical High $25.12 | Facility | None | $18.62 | $22.91 | $25.12 |
Moda Health Setting Professional Modifier None Typical Low $18.62 Median $22.91 Typical High $25.12 | Professional | None | $18.62 | $22.91 | $25.12 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $31.62 | Professional | None | $26.92 | $30.20 | $31.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $20.42 Median $23.44 Typical High $30.90 | Facility | None | $20.42 | $23.44 | $30.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $24.55 | Professional | None | $22.91 | $23.44 | $24.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $15.14 Median $60.26 Typical High $117.49 | Facility | None | $15.14 | $60.26 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | None | $18.62 | $22.39 | $22.39 |
Select Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $38.02 | Facility | None | $18.62 | $18.62 | $38.02 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $25.70 | Professional | None | $18.20 | $18.62 | $25.70 |
United Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | None | $20.42 | $20.42 | $21.38 |
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 $9.33 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $9.33 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.72 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $2.82 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.86 | $2.29 | $2.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $13.49 Median $14.13 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $13.49 | $14.13 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $10.96 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.47 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.31 | $3.80 | $3.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.19 | $2.51 | $2.51 |
Where Idaho sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 21st of 51
$20.42
HI $33.11OH $18.62
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.