How much rates vary
Facilitymedian $93 · 10th to 90th $62 to $138Professionalmedian $79 · 10th to 90th $60 to $115
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 $77.62 Median $81.28 Typical High $107.15 | Facility | None | $77.62 | $81.28 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $87.10 | Professional | None | $54.95 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $31.62 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $13.18 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.31 | $6.76 | $8.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $114.82 Typical High $239.88 | Facility | None | $77.62 | $114.82 | $239.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $125.89 | Professional | None | $70.79 | $87.10 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $102.33 | Professional | None | $56.23 | $79.43 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $102.33 | Facility | None | $60.26 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $112.20 | Professional | None | $63.10 | $87.10 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $31.62 | $33.88 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $13.18 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.31 | $6.76 | $8.71 |
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 $75.86 Median $75.86 Typical High $114.82 | Facility | None | $75.86 | $75.86 | $114.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $117.49 | Professional | None | $75.86 | $77.62 | $117.49 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $9.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $147.91 | Facility | None | $93.33 | $100.00 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $112.20 | Professional | None | $66.07 | $87.10 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $89.13 | Professional | None | $48.98 | $63.10 | $89.13 |
United Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $100.00 | Professional | None | $53.70 | $70.79 | $100.00 |
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 $50.12 Median $58.88 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $50.12 | $58.88 | $87.10 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $66.07 | Professional | 54 · Surgery only | $51.29 | $51.29 | $66.07 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $54.95 | $54.95 | $70.79 |
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
$79.43
AK $126DC $46.77
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.