How much rates vary
Facilitymedian $263 · 10th to 90th $224 to $437Professionalmedian $234 · 10th to 90th $123 to $10,000
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 $218.78 Median $234.42 Typical High $234.42 | Professional | None | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $23.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $436.52 | Facility | None | $213.80 | $263.03 | $436.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $234.42 Typical High $338.84 | Facility | None | $218.78 | $234.42 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $288.40 | Professional | None | $218.78 | $234.42 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $109.65 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $43.65 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $23.44 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $151.36 Typical High $218.78 | Professional | None | $30.20 | $151.36 | $218.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $16,218.10 | Facility | None | $338.84 | $338.84 | $16,218.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $67.61 Median $338.84 Typical High $19,054.61 | Professional | None | $67.61 | $338.84 | $19,054.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $389.05 | Facility | None | $257.04 | $263.03 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $346.74 | Facility | None | $275.42 | $275.42 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $537.03 | Professional | None | $263.03 | $275.42 | $537.03 |
United Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $134.90 | Professional | None | $104.71 | $125.89 | $134.90 |
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 $199.53 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $208.93 |
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 3.2 times more in Minnesota than in New York. 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· 13th of 51
$234
MN $363NY $115
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.