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 $72.44 Median $91.20 Typical High $93.33 | Professional | None | $72.44 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $40.74 | $45.71 | $45.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $371.54 | Facility | None | $257.04 | $309.03 | $371.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $154.88 | Professional | None | $104.71 | $112.20 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $117.49 | Professional | None | $83.18 | $104.71 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $97.72 | Facility | None | $77.62 | $91.20 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $128.82 | Professional | None | $81.28 | $93.33 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $40.74 | $45.71 | $45.71 |
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 $114.82 Median $114.82 Typical High $141.25 | Facility | None | $114.82 | $114.82 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | None | $107.15 | $117.49 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $128.82 | Professional | None | $89.13 | $107.15 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Facility | None | $74.13 | $74.13 | $75.86 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $131.83 | Professional | None | $74.13 | $85.11 | $131.83 |
United Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $125.89 | Professional | None | $75.86 | $93.33 | $125.89 |
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 $74.13 Median $87.10 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $74.13 | $87.10 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 54 · Surgery only | $74.13 | $74.13 | $75.86 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $81.28 |
Where Idaho sits
The same service costs 3.0 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· 10th of 51
$105
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.