How much rates vary
Facilitymedian $145 · 10th to 90th $123 to $229Professionalmedian $123 · 10th to 90th $58 to $5,248
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 $107.15 Median $123.03 Typical High $123.03 | Professional | None | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $53.70 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $21.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $12.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $229.09 | Facility | None | $117.49 | $138.04 | $229.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $123.03 Typical High $173.78 | Facility | None | $114.82 | $123.03 | $173.78 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | None | $114.82 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $56.23 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $22.39 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.60 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.22 | $12.30 | $12.30 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $25.12 | Professional | None | $4.27 | $5.01 | $25.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $8,511.38 | Facility | None | $177.83 | $177.83 | $8,511.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $35.48 Median $177.83 Typical High $10,000.00 | Professional | None | $35.48 | $177.83 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $138.04 Typical High $204.17 | Facility | None | $134.90 | $138.04 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $144.54 Typical High $181.97 | Facility | None | $131.83 | $144.54 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $281.84 | Professional | None | $125.89 | $144.54 | $281.84 |
United Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $63.10 | Professional | None | $48.98 | $58.88 | $63.10 |
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 $104.71 Median $104.71 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $109.65 |
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 2.5 times more in Minnesota than in Utah. 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· 6th of 51
$123
MN $151UT $61.66
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.