How much rates vary
Facilitymedian $162 · 10th to 90th $110 to $263Professionalmedian $135 · 10th to 90th $100 to $209
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 $100.00 Median $109.65 Typical High $154.88 | Professional | None | $100.00 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $15.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $380.19 | Facility | None | $169.82 | $229.09 | $380.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $229.09 | Professional | None | $114.82 | $144.54 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $181.97 | Professional | None | $91.20 | $131.83 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $158.49 | Facility | None | $83.18 | $114.82 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $199.53 | Professional | None | $102.33 | $141.25 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $54.95 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $15.49 | $16.60 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $15.49 |
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 $123.03 Median $123.03 Typical High $208.93 | Facility | None | $123.03 | $123.03 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $213.80 | Professional | None | $123.03 | $125.89 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $18.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $181.97 Typical High $275.42 | Facility | None | $169.82 | $181.97 | $275.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $199.53 | Professional | None | $114.82 | $141.25 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $114.82 | Facility | None | $112.20 | $112.20 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $144.54 | Professional | None | $83.18 | $112.20 | $144.54 |
United Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $181.97 | Professional | None | $87.10 | $123.03 | $181.97 |
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 $81.28 Median $95.50 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $165.96 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $165.96 Typical High $436.52 | Professional | 25 · Same-day visit | $104.71 | $165.96 | $436.52 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $128.82 | Professional | 54 · Surgery only | $89.13 | $89.13 | $128.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $138.04 |
Where Idaho sits
The same service costs 2.8 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
$135
AK $219DC $77.62
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.