How much rates vary
Facilitymedian $224 · 10th to 90th $148 to $339Professionalmedian $191 · 10th to 90th $141 to $275
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 $123.03 Median $162.18 Typical High $208.93 | Professional | None | $123.03 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $20.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $478.63 | Facility | None | $223.87 | $295.12 | $478.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $302.00 | Professional | None | $165.96 | $204.17 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $239.88 | Professional | None | $134.90 | $190.55 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $162.18 Typical High $208.93 | Facility | None | $117.49 | $162.18 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $263.03 | Professional | None | $151.36 | $199.53 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $20.89 |
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 $181.97 Median $181.97 Typical High $275.42 | Facility | None | $181.97 | $181.97 | $275.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $281.84 | Professional | None | $181.97 | $186.21 | $281.84 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $23.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $354.81 | Facility | None | $223.87 | $239.88 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $263.03 | Professional | None | $158.49 | $204.17 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | None | $120.23 | $147.91 | $208.93 |
United Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $239.88 | Professional | None | $125.89 | $165.96 | $239.88 |
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 $117.49 Median $144.54 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $117.49 | $144.54 | $204.17 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $234.42 Typical High $676.08 | Professional | 25 · Same-day visit | $123.03 | $234.42 | $676.08 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $181.97 |
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· 9th of 51
$191
AK $295DC $110
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.