How much rates vary
Facilitymedian $55 · 10th to 90th $34 to $87Professionalmedian $43 · 10th to 90th $31 to $69
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 $39.81 Median $39.81 Typical High $67.61 | Facility | None | $39.81 | $39.81 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $52.48 | Professional | None | $30.90 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.60 Typical High $26.30 | Professional | 52 · Reduced service | $15.49 | $16.60 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.01 Typical High $7.94 | Professional | 55 · Aftercare only | $4.68 | $5.01 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $5.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $12.02 Median $61.66 Typical High $141.25 | Facility | None | $12.02 | $61.66 | $141.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $77.62 | Professional | None | $34.67 | $48.98 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $61.66 | Professional | None | $28.84 | $38.90 | $61.66 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $40.74 Typical High $58.88 | Facility | None | $28.18 | $40.74 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $67.61 | Professional | None | $33.88 | $42.66 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.60 Typical High $26.30 | Professional | 52 · Reduced service | $15.49 | $16.60 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.01 Typical High $7.94 | Professional | 55 · Aftercare only | $4.68 | $5.01 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $5.25 |
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 $37.15 Median $37.15 Typical High $70.79 | Facility | None | $37.15 | $37.15 | $70.79 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $72.44 | Professional | None | $37.15 | $38.90 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $91.20 | Facility | None | $57.54 | $61.66 | $91.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $67.61 | Professional | None | $34.67 | $42.66 | $67.61 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.02 | Facility | None | $37.15 | $37.15 | $38.02 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $43.65 | Professional | None | $23.99 | $37.15 | $43.65 |
United Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $58.88 | Professional | None | $26.30 | $38.90 | $58.88 |
3 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 $24.55 Median $28.84 Typical High $56.23 | Professional | 78 · Unplanned return to OR | $24.55 | $28.84 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $40.74 | Professional | 54 · Surgery only | $25.12 | $25.12 | $40.74 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $26.92 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $26.92 | $26.92 | $43.65 |
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· 11th of 51
$42.66
AK $66.07DC $23.99
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.