How much rates vary
Facilitymedian $52 · 10th to 90th $35 to $89Professionalmedian $58 · 10th to 90th $25 to $74
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 Professional Modifier None Typical Low $30.90 Median $74.13 Typical High $74.13 | Professional | None | $30.90 | $74.13 | $74.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $87.10 | Facility | None | $51.29 | $52.48 | $87.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $60.26 | Professional | None | $38.90 | $57.54 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $37.15 | Facility | None | $35.48 | $35.48 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $74.13 | Facility | None | $35.48 | $52.48 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $74.13 | Professional | None | $36.31 | $57.54 | $74.13 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $38.90 | Professional | None | $30.20 | $38.02 | $38.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $3,311.31 | Facility | None | $66.07 | $69.18 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $3,890.45 | Professional | None | $54.95 | $69.18 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $79.43 | Facility | None | $51.29 | $52.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $57.54 | Professional | None | $38.90 | $38.90 | $57.54 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Facility | None | $54.95 | $54.95 | $56.23 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $60.26 | Professional | None | $35.48 | $54.95 | $60.26 |
United Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $38.02 | Professional | None | $23.44 | $24.55 | $38.02 |
9 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $15.49 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $6.17 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $4.57 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.09 | $7.41 | $7.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $40.74 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $36.31 | $40.74 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $15.49 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $6.17 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $4.57 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.09 | $7.41 | $7.41 |
Where Idaho sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 2nd of 51
$57.54
HI $57.54UT $25.70
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.