How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $34.67 Median $40.74 Typical High $50.12 | Professional | None | $34.67 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $19.50 Typical High $25.12 | Professional | 52 · Reduced service | $17.38 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.76 Typical High $10.00 | Professional | 53 · Discontinued | $6.92 | $7.76 | $10.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $81.28 | Professional | None | $44.67 | $53.70 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $64.57 | Professional | None | $35.48 | $51.29 | $64.57 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $40.74 Typical High $52.48 | Facility | None | $33.11 | $40.74 | $52.48 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $69.18 | Professional | None | $38.02 | $50.12 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $19.50 Typical High $25.12 | Professional | 52 · Reduced service | $17.38 | $19.50 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.76 Typical High $10.00 | Professional | 53 · Discontinued | $6.92 | $7.76 | $10.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $74.13 | Facility | None | $47.86 | $47.86 | $74.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $75.86 | Professional | None | $47.86 | $48.98 | $75.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $69.18 | Professional | None | $41.69 | $53.70 | $69.18 |
Select Health Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $39.81 | Facility | None | $38.90 | $38.90 | $39.81 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $57.54 | Professional | None | $28.84 | $38.90 | $57.54 |
United Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $64.57 | Professional | None | $34.67 | $44.67 | $64.57 |
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 $30.90 Median $35.48 Typical High $56.23 | Professional | 78 · Unplanned return to OR | $30.90 | $35.48 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | 54 · Surgery only | $31.62 | $31.62 | $41.69 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.89 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $33.88 | $33.88 | $44.67 |
Where Idaho sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 9th of 51
$50.12
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.