How much rates vary
Facilitymedian $141 · 10th to 90th $91 to $214Professionalmedian $115 · 10th to 90th $81 to $182
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 Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $158.49 | Facility | None | $112.20 | $112.20 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $134.90 | Professional | None | $75.86 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $67.61 | Professional | 52 · Reduced service | $43.65 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $13.49 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $275.42 | Facility | None | $147.91 | $194.98 | $275.42 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $199.53 | Professional | None | $97.72 | $123.03 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $158.49 | Professional | None | $79.43 | $112.20 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $141.25 | Facility | None | $81.28 | $100.00 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $173.78 | Professional | None | $85.11 | $120.23 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $67.61 | Professional | 52 · Reduced service | $43.65 | $47.86 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $13.49 |
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 $107.15 Median $107.15 Typical High $181.97 | Facility | None | $107.15 | $107.15 | $181.97 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $186.21 | Professional | None | $107.15 | $109.65 | $186.21 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $15.85 |
Regence BlueShield Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $234.42 | Facility | None | $147.91 | $154.88 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $173.78 | Professional | None | $95.50 | $120.23 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $100.00 | Facility | None | $97.72 | $97.72 | $100.00 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $123.03 | Professional | None | $70.79 | $97.72 | $123.03 |
United Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $154.88 | Professional | None | $74.13 | $107.15 | $154.88 |
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 $69.18 Median $109.65 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $69.18 | $109.65 | $141.25 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $181.97 Typical High $426.58 | Professional | 25 · Same-day visit | $91.20 | $181.97 | $426.58 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | 54 · Surgery only | $75.86 | $75.86 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $81.28 | $81.28 | $117.49 |
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
$115
AK $186DC $64.57
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.