How much rates vary
Facilitymedian $145 · 10th to 90th $89 to $263Professionalmedian $83 · 10th to 90th $66 to $117
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 Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $117.49 | Facility | None | $89.13 | $93.33 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $81.28 | Professional | None | $66.07 | $77.62 | $81.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $234.42 | Facility | None | $107.15 | $144.54 | $234.42 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | None | $81.28 | $102.33 | $120.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $79.43 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $58.88 | $79.43 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $97.72 | Professional | None | $69.18 | $81.28 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $218.78 Typical High $398.11 | Facility | None | $77.62 | $218.78 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $114.82 | Professional | None | $70.79 | $77.62 | $114.82 |
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 $89.13 Median $100.00 Typical High $100.00 | Facility | None | $89.13 | $100.00 | $100.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $102.33 | Professional | None | $83.18 | $100.00 | $102.33 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $63.10 | $63.10 | $63.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $229.09 | Facility | None | $120.23 | $173.78 | $229.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $100.00 | Professional | None | $69.18 | $81.28 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $199.53 | Facility | None | $52.48 | $53.70 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $102.33 | Professional | None | $52.48 | $66.07 | $102.33 |
United Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $109.65 | Professional | None | $61.66 | $81.28 | $109.65 |
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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 22 · Increased work | $91.20 | $91.20 | $91.20 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 54 · Surgery only | $58.88 | $58.88 | $58.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 63 · Small infant | $91.20 | $91.20 | $91.20 |
Where Idaho sits
The same service costs 4.6 times more in Alaska 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· 20th of 51
$83.18
AK $151UT $33.11
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.