How much rates vary
Facilitymedian $65 · 10th to 90th $42 to $145Professionalmedian $58 · 10th to 90th $39 to $100
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 $50.12 Median $64.57 Typical High $85.11 | Facility | None | $50.12 | $64.57 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $69.18 | Professional | None | $36.31 | $52.48 | $69.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $9.55 Median $40.74 Typical High $158.49 | Facility | None | $9.55 | $40.74 | $158.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $114.82 | Professional | None | $51.29 | $72.44 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $89.13 | Professional | None | $40.74 | $57.54 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $186.21 | Facility | None | $40.74 | $69.18 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $97.72 | Professional | None | $39.81 | $56.23 | $97.72 |
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 $56.23 Median $56.23 Typical High $104.71 | Facility | None | $56.23 | $56.23 | $104.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $107.15 | Professional | None | $56.23 | $66.07 | $107.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $100.00 | Professional | None | $48.98 | $63.10 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $56.23 Typical High $56.23 | Facility | None | $37.15 | $56.23 | $56.23 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $93.33 | Professional | None | $36.31 | $56.23 | $93.33 |
United Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $69.18 | Professional | None | $27.54 | $46.77 | $69.18 |
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 $19.95 Median $22.39 Typical High $34.67 | Professional | 52 · Reduced service | $19.95 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.76 Typical High $10.47 | Professional | 55 · Aftercare only | $5.89 | $6.76 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.98 | $4.57 | $6.92 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $46.77 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $37.15 | $46.77 | $83.18 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $33.11 Median $63.10 Typical High $154.88 | Professional | 25 · Same-day visit | $33.11 | $63.10 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $22.39 Typical High $34.67 | Professional | 52 · Reduced service | $19.95 | $22.39 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.76 Typical High $10.47 | Professional | 55 · Aftercare only | $5.89 | $6.76 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.98 | $4.57 | $6.92 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $46.77 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $46.77 | $74.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $10.47 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $50.12 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $50.12 | $50.12 | $79.43 |
Where Idaho sits
The same service costs 2.4 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· 8th of 51
$57.54
AK $77.62NJ $32.36
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.