How much rates vary
Facilitymedian $145 · 10th to 90th $79 to $1,288Professionalmedian $132 · 10th to 90th $87 to $178
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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $169.82 | Professional | None | $85.11 | $123.03 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $346.74 Typical High $1,348.96 | Facility | None | $117.49 | $346.74 | $1,348.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $154.88 | Professional | None | $123.03 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $177.83 | Professional | None | $125.89 | $154.88 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $134.90 Typical High $208.93 | Facility | None | $79.43 | $134.90 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $239.88 | Professional | None | $85.11 | $123.03 | $239.88 |
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 $120.23 Median $131.83 Typical High $131.83 | Facility | None | $120.23 | $131.83 | $131.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | None | $131.83 | $131.83 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | None | $123.03 | $123.03 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $1,348.96 | Facility | None | $70.79 | $70.79 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $131.83 | Professional | None | $70.79 | $70.79 | $131.83 |
United Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $181.97 | Professional | None | $89.13 | $128.82 | $181.97 |
8 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 $38.02 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $38.02 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $11.48 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $12.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $102.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $85.11 | $102.33 | $107.15 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $81.28 Median $234.42 Typical High $501.19 | Professional | 25 · Same-day visit | $81.28 | $234.42 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $12.30 | $12.30 |
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· 11th of 51
$132
AK $174AL $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.