How much rates vary
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 Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $194.98 | Professional | None | $107.15 | $158.49 | $194.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.41 Median $100.00 Typical High $100.00 | Facility | None | $7.41 | $100.00 | $100.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | None | $144.54 | $165.96 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $234.42 | Professional | None | $158.49 | $199.53 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $177.83 Typical High $275.42 | Facility | None | $162.18 | $177.83 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $275.42 | Professional | None | $114.82 | $162.18 | $275.42 |
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 $144.54 Median $158.49 Typical High $158.49 | Facility | None | $144.54 | $158.49 | $158.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | None | $158.49 | $158.49 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | None | $144.54 | $144.54 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $87.10 | Facility | None | $83.18 | $83.18 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | None | $83.18 | $83.18 | $158.49 |
United Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $239.88 | Professional | None | $109.65 | $173.78 | $239.88 |
7 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 $50.12 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.00 | $16.22 | $16.22 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $58.88 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.02 | $16.22 | $16.22 |
Where Idaho sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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
$162
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.