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 $66.07 Median $81.28 Typical High $81.28 | Professional | None | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $33.11 | $40.74 | $40.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | None | $79.43 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $104.71 | Professional | None | $74.13 | $93.33 | $104.71 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $117.49 | Facility | None | $72.44 | $81.28 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $114.82 | Professional | None | $72.44 | $81.28 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $36.31 | $40.74 | $40.74 |
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 $91.20 Median $100.00 Typical High $100.00 | Facility | None | $91.20 | $100.00 | $100.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | None | $95.50 | $100.00 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | None | $79.43 | $93.33 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Facility | None | $53.70 | $53.70 | $54.95 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $117.49 | Professional | None | $53.70 | $67.61 | $117.49 |
United Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $123.03 | Professional | None | $69.18 | $91.20 | $123.03 |
5 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 22 · Increased work | $104.71 | $104.71 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 54 · Surgery only | $67.61 | $67.61 | $67.61 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 63 · Small infant | $104.71 | $104.71 | $104.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $72.44 |
Where Idaho sits
The same service costs 2.8 times more in Alaska than in Florida. 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· 13th of 51
$93.33
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.