How much rates vary
Facilitymedian $85 · 10th to 90th $48 to $123Professionalmedian $71 · 10th to 90th $49 to $93
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $60.26 Median $70.79 Typical High $77.62 | Professional | None | $60.26 | $70.79 | $77.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $123.03 | Facility | None | $61.66 | $85.11 | $123.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $100.00 | Professional | None | $60.26 | $70.79 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $83.18 | Professional | None | $48.98 | $67.61 | $83.18 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $109.65 | Facility | None | $70.79 | $70.79 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $91.20 | Professional | None | $58.88 | $70.79 | $91.20 |
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 $81.28 Median $89.13 Typical High $89.13 | Facility | None | $81.28 | $89.13 | $89.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.02 Median $89.13 Typical High $91.20 | Professional | None | $12.02 | $89.13 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $70.79 Median $97.72 Typical High $123.03 | Facility | None | $70.79 | $97.72 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | None | $70.79 | $70.79 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $48.98 | Facility | None | $47.86 | $47.86 | $48.98 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $77.62 | Professional | None | $43.65 | $47.86 | $77.62 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $102.33 | Professional | None | $56.23 | $75.86 | $102.33 |
10 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 $33.11 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $14.13 | $15.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $66.07 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $36.31 | $66.07 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $35.48 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $14.13 | $14.13 | $15.49 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 22 · Increased work | $57.54 | $57.54 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 54 · Surgery only | $36.31 | $36.31 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 63 · Small infant | $57.54 | $57.54 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 78 · Unplanned return to OR | $38.90 | $38.90 | $38.90 |
Where Idaho sits
The same service costs 2.6 times more in Nebraska than in Kentucky. 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· 17th of 51
$70.79
NE $105KY $40.74
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.