How much rates vary
Facilitymedian $155 · 10th to 90th $100 to $251Professionalmedian $126 · 10th to 90th $93 to $204
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 Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $147.91 | Professional | None | $91.20 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $52.48 Typical High $74.13 | Professional | 52 · Reduced service | $47.86 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $14.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $354.81 | Facility | None | $162.18 | $218.78 | $354.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $223.87 | Professional | None | $107.15 | $138.04 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $173.78 | Professional | None | $87.10 | $123.03 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $151.36 | Facility | None | $75.86 | $109.65 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $190.55 | Professional | None | $97.72 | $131.83 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $52.48 Typical High $74.13 | Professional | 52 · Reduced service | $47.86 | $52.48 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $14.79 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $204.17 | Facility | None | $114.82 | $114.82 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $204.17 | Professional | None | $114.82 | $117.49 | $204.17 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $17.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $263.03 | Facility | None | $162.18 | $173.78 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $190.55 | Professional | None | $107.15 | $131.83 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $109.65 | Facility | None | $107.15 | $107.15 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $134.90 | Professional | None | $77.62 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $173.78 | Professional | None | $81.28 | $117.49 | $173.78 |
4 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $89.13 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $89.13 | $158.49 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $173.78 Typical High $416.87 | Professional | 25 · Same-day visit | $97.72 | $173.78 | $416.87 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $83.18 | $123.03 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $131.83 |
Where Idaho sits
The same service costs 2.9 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· 13th of 51
$126
AK $204DC $70.79
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.