How much rates vary
Facilitymedian $138 · 10th to 90th $89 to $186Professionalmedian $132 · 10th to 90th $91 to $200
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 $104.71 Median $144.54 Typical High $186.21 | Facility | None | $104.71 | $144.54 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $154.88 | Professional | None | $89.13 | $123.03 | $154.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.98 Median $77.62 Typical High $87.10 | Facility | None | $3.98 | $77.62 | $87.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $229.09 | Professional | None | $117.49 | $151.36 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $177.83 | Professional | None | $93.33 | $134.90 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $138.04 Typical High $177.83 | Facility | None | $91.20 | $138.04 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $194.98 | Professional | None | $89.13 | $131.83 | $194.98 |
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 $128.82 Median $128.82 Typical High $208.93 | Facility | None | $128.82 | $128.82 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | None | $128.82 | $151.36 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | None | $112.20 | $147.91 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $109.65 Typical High $112.20 | Facility | None | $64.57 | $109.65 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $380.19 | Professional | None | $83.18 | $125.89 | $380.19 |
United Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $165.96 | Professional | None | $81.28 | $114.82 | $165.96 |
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 $45.71 Median $52.48 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $13.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $107.15 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $81.28 | $107.15 | $165.96 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $63.10 Median $138.04 Typical High $389.05 | Professional | 25 · Same-day visit | $63.10 | $138.04 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $52.48 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $52.48 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $13.80 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $107.15 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $20.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $154.88 |
Where Idaho sits
The same service costs 2.3 times more in Alaska 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· 10th of 51
$132
AK $170AL $74.13
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.