How much rates vary
Facilitymedian $158 · 10th to 90th $102 to $245Professionalmedian $145 · 10th to 90th $107 to $214
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 $95.50 Median $120.23 Typical High $158.49 | Professional | None | $95.50 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $15.85 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $181.97 Typical High $281.84 | Facility | None | $72.44 | $181.97 | $281.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $239.88 | Professional | None | $125.89 | $154.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $186.21 | Professional | None | $100.00 | $141.25 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $158.49 | Facility | None | $87.10 | $120.23 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $204.17 | Professional | None | $109.65 | $154.88 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $60.26 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $15.85 |
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 $134.90 Median $134.90 Typical High $218.78 | Facility | None | $134.90 | $134.90 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $218.78 | Professional | None | $134.90 | $138.04 | $218.78 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $18.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $186.21 Typical High $281.84 | Facility | None | $173.78 | $186.21 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $204.17 | Professional | None | $117.49 | $154.88 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $117.49 | Facility | None | $114.82 | $114.82 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $158.49 | Professional | None | $91.20 | $114.82 | $158.49 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $186.21 | Professional | None | $95.50 | $128.82 | $186.21 |
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 $89.13 Median $120.23 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $89.13 | $120.23 | $169.82 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $194.98 Typical High $446.68 | Professional | 25 · Same-day visit | $95.50 | $194.98 | $446.68 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $97.72 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $141.25 |
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· 11th of 51
$145
AK $224DC $83.18
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.