How much rates vary
Facilitymedian $191 · 10th to 90th $126 to $295Professionalmedian $158 · 10th to 90th $117 to $240
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 $107.15 Median $134.90 Typical High $177.83 | Professional | None | $107.15 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $17.78 |
BCBS Idaho Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $407.38 | Facility | None | $194.98 | $257.04 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $263.03 | Professional | None | $138.04 | $169.82 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $208.93 | Professional | None | $109.65 | $154.88 | $208.93 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $177.83 | Facility | None | $97.72 | $134.90 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $229.09 | Professional | None | $123.03 | $169.82 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $66.07 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $17.78 |
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 $147.91 Median $147.91 Typical High $239.88 | Facility | None | $147.91 | $147.91 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $245.47 | Professional | None | $147.91 | $151.36 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $20.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $204.17 Typical High $309.03 | Facility | None | $194.98 | $204.17 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $229.09 | Professional | None | $128.82 | $169.82 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $128.82 | Facility | None | $125.89 | $125.89 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $173.78 | Professional | None | $100.00 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $204.17 | Professional | None | $104.71 | $141.25 | $204.17 |
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 $97.72 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $181.97 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $204.17 Typical High $562.34 | Professional | 25 · Same-day visit | $112.20 | $204.17 | $562.34 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $107.15 | $144.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $154.88 |
Where Idaho sits
The same service costs 2.7 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
$158
AK $251DC $93.33
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.