How much rates vary
Facilitymedian $170 · 10th to 90th $115 to $269Professionalmedian $141 · 10th to 90th $105 to $219
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 $117.49 Typical High $162.18 | Professional | None | $100.00 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $16.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $371.54 | Facility | None | $177.83 | $234.42 | $371.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $239.88 | Professional | None | $123.03 | $151.36 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $190.55 | Professional | None | $97.72 | $138.04 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $120.23 Typical High $162.18 | Facility | None | $85.11 | $120.23 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $208.93 | Professional | None | $109.65 | $147.91 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $58.88 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $16.22 |
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 $131.83 Median $131.83 Typical High $218.78 | Facility | None | $131.83 | $131.83 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $223.87 | Professional | None | $131.83 | $134.90 | $223.87 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $19.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $177.83 Median $190.55 Typical High $281.84 | Facility | None | $177.83 | $190.55 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $208.93 | Professional | None | $117.49 | $147.91 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $154.88 | Professional | None | $89.13 | $117.49 | $154.88 |
United Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $181.97 | Professional | None | $93.33 | $128.82 | $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 $85.11 Median $100.00 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $85.11 | $100.00 | $173.78 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $177.83 Typical High $457.09 | Professional | 25 · Same-day visit | $104.71 | $177.83 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $93.33 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $144.54 |
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· 12th of 51
$141
AK $229DC $81.28
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.