How much rates vary
Facilitymedian $129 · 10th to 90th $110 to $209Professionalmedian $115 · 10th to 90th $45 to $4,898
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 $85.11 Median $114.82 Typical High $114.82 | Professional | None | $85.11 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $42.66 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $16.98 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.51 | $11.48 | $11.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $208.93 | Facility | None | $97.72 | $125.89 | $208.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $114.82 Typical High $162.18 | Facility | None | $107.15 | $114.82 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $138.04 | Professional | None | $107.15 | $114.82 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $45.71 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $18.20 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.12 | $11.48 | $11.48 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $44.67 | Professional | None | $30.20 | $38.02 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $7,943.28 | Facility | None | $165.96 | $165.96 | $7,943.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $9,332.54 | Professional | None | $33.11 | $165.96 | $9,332.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $190.55 | Facility | None | $123.03 | $125.89 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $169.82 | Facility | None | $123.03 | $131.83 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $263.03 | Professional | None | $102.33 | $131.83 | $263.03 |
United Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $48.98 | Professional | None | $38.02 | $46.77 | $48.98 |
4 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $97.72 | $97.72 | $102.33 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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· 2nd of 51
$115
HI $126IN $47.86
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.