How much rates vary
Facilitymedian $87 · 10th to 90th $54 to $129Professionalmedian $85 · 10th to 90th $60 to $129
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 $61.66 Median $95.50 Typical High $128.82 | Facility | None | $61.66 | $95.50 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $107.15 | Professional | None | $54.95 | $83.18 | $107.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.63 Median $52.48 Typical High $57.54 | Facility | None | $2.63 | $52.48 | $57.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $144.54 | Professional | None | $69.18 | $91.20 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $114.82 | Professional | None | $57.54 | $79.43 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $112.20 | Facility | None | $53.70 | $89.13 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $123.03 | Professional | None | $61.66 | $89.13 | $123.03 |
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 $74.13 Median $74.13 Typical High $131.83 | Facility | None | $74.13 | $74.13 | $131.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $134.90 | Professional | None | $74.13 | $89.13 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $125.89 | Professional | None | $69.18 | $85.11 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $72.44 | Facility | None | $47.86 | $70.79 | $72.44 |
Select Health Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $281.84 | Professional | None | $47.86 | $72.44 | $281.84 |
United Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $114.82 | Professional | None | $53.70 | $77.62 | $114.82 |
11 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 $26.92 Median $30.20 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $30.20 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.12 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $9.12 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.17 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $6.17 | $8.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $61.66 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $47.86 | $61.66 | $102.33 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $58.88 Median $97.72 Typical High $281.84 | Professional | 25 · Same-day visit | $58.88 | $97.72 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $30.20 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $30.20 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.12 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $9.12 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.17 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $6.17 | $8.91 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $93.33 | Professional | 54 · Surgery only | $61.66 | $61.66 | $93.33 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $13.49 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $66.07 | $100.00 |
Where Idaho sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 7th of 51
$85.11
AK $107NJ $48.98
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.