How much rates vary
Facilitymedian $339 · 10th to 90th $33 to $813Professionalmedian $32 · 10th to 90th $28 to $39
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 $28.18 Median $29.51 Typical High $29.51 | Professional | None | $28.18 | $29.51 | $29.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $93.33 Median $338.84 Typical High $707.95 | Facility | None | $93.33 | $338.84 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $38.90 | Professional | None | $31.62 | $33.11 | $38.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $23.99 Typical High $28.18 | Professional | 78 · Unplanned return to OR | $22.91 | $23.99 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $38.02 | Professional | None | $30.90 | $34.67 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $29.51 Typical High $42.66 | Facility | None | $25.70 | $29.51 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $38.90 | Professional | None | $28.18 | $29.51 | $38.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $29.51 Median $33.11 Typical High $33.11 | Facility | None | $29.51 | $33.11 | $33.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | None | $33.11 | $33.11 | $33.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,023.29 | Facility | None | $309.03 | $602.56 | $1,023.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $38.90 | Professional | None | $27.54 | $31.62 | $38.90 |
Select Health Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $323.59 | Facility | None | $17.38 | $17.38 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $17.38 Median $24.55 Typical High $33.11 | Professional | None | $17.38 | $24.55 | $33.11 |
United Setting Professional Modifier None Typical Low $22.91 Median $31.62 Typical High $40.74 | Professional | None | $22.91 | $31.62 | $40.74 |
8 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 $12.30 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $4.90 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.72 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.95 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.13 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.62 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.17 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $2.95 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Florida. 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· 11th of 51
$33.11
AK $54.95FL $19.50
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.