How much rates vary
Facilitymedian $95 · 10th to 90th $83 to $162Professionalmedian $85 · 10th to 90th $35 to $123
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 $63.10 Median $85.11 Typical High $85.11 | Professional | None | $63.10 | $85.11 | $85.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $158.49 | Facility | None | $77.62 | $95.50 | $158.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $109.65 | Professional | None | $69.18 | $104.71 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $123.03 | Facility | None | $79.43 | $85.11 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $104.71 | Professional | None | $79.43 | $85.11 | $104.71 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | None | $56.23 | $56.23 | $67.61 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $6,025.60 | Facility | None | $123.03 | $123.03 | $6,025.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $25.12 Median $123.03 Typical High $6,918.31 | Professional | None | $25.12 | $123.03 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $141.25 | Facility | None | $93.33 | $95.50 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $104.71 | Professional | None | $69.18 | $69.18 | $104.71 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $128.82 | Facility | None | $95.50 | $100.00 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $194.98 | Professional | None | $93.33 | $100.00 | $194.98 |
United Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $36.31 | Professional | None | $28.84 | $34.67 | $36.31 |
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 $31.62 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $31.62 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $12.59 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $9.55 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.31 | $8.51 | $8.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
Where Idaho sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 3rd of 51
$85.11
MT $100AL $36.31
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.