How much rates vary
Facilitymedian $46 · 10th to 90th $31 to $69Professionalmedian $45 · 10th to 90th $34 to $56
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 $42.66 Median $42.66 Typical High $43.65 | Facility | None | $42.66 | $42.66 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $46.77 | Professional | None | $30.20 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $20.42 | $21.38 | $21.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $18.20 Median $48.98 Typical High $74.13 | Facility | None | $18.20 | $48.98 | $74.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $63.10 | Professional | None | $44.67 | $48.98 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $53.70 | Professional | None | $36.31 | $46.77 | $53.70 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $46.77 | Facility | None | $35.48 | $42.66 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $56.23 | Professional | None | $33.88 | $43.65 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $20.42 | $21.38 | $21.88 |
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 $47.86 Median $47.86 Typical High $57.54 | Facility | None | $47.86 | $47.86 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $58.88 | Professional | None | $46.77 | $48.98 | $58.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $74.13 | Facility | None | $45.71 | $48.98 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $56.23 | Professional | None | $38.90 | $45.71 | $56.23 |
Select Health Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Facility | None | $30.20 | $30.20 | $31.62 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $54.95 | Professional | None | $30.20 | $37.15 | $54.95 |
United Setting Professional Modifier None Typical Low $30.20 Median $40.74 Typical High $56.23 | Professional | None | $30.20 | $40.74 | $56.23 |
8 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 $30.90 Median $36.31 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $30.90 | $36.31 | $43.65 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $29.51 Median $66.07 Typical High $131.83 | Professional | 25 · Same-day visit | $29.51 | $66.07 | $131.83 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 50 · Both sides | $67.61 | $67.61 | $70.79 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 54 · Surgery only | $31.62 | $31.62 | $33.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.68 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 62 · Two surgeons | $28.18 | $28.18 | $29.51 |
MountainHealth Co-op Setting Professional Modifier 66 · Surgical team Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | 66 · Surgical team | $20.42 | $20.42 | $20.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $33.88 | $33.88 | $35.48 |
Where Idaho sits
The same service costs 2.5 times more in Alaska than in New York. 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· 8th of 51
$44.67
AK $60.26NY $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.