How much rates vary
Facilitymedian $145 · 10th to 90th $129 to $240Professionalmedian $129 · 10th to 90th $69 to $5,623
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 $120.23 Median $128.82 Typical High $128.82 | Professional | None | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $12.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $239.88 | Facility | None | $117.49 | $144.54 | $239.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $128.82 Typical High $186.21 | Facility | None | $120.23 | $128.82 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $158.49 | Professional | None | $120.23 | $128.82 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $12.88 |
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 $190.55 Median $190.55 Typical High $9,120.11 | Facility | None | $190.55 | $190.55 | $9,120.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $38.02 Median $190.55 Typical High $10,715.19 | Professional | None | $38.02 | $190.55 | $10,715.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $218.78 | Facility | None | $141.25 | $144.54 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $194.98 | Facility | None | $151.36 | $151.36 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $302.00 | Professional | None | $147.91 | $162.18 | $302.00 |
United Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $74.13 | Professional | None | $57.54 | $70.79 | $74.13 |
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 $109.65 Median $112.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $109.65 | $112.20 | $117.49 |
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 Montana 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· 15th of 51
$129
MT $186OH $72.44
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.