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 $61.66 Median $67.61 Typical High $67.61 | Professional | None | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.59 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $6.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | None | $104.71 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $67.61 Typical High $95.50 | Facility | None | $61.66 | $67.61 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | None | $61.66 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.90 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.59 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $6.61 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $77.62 | Professional | None | $30.20 | $30.20 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $125.89 | Facility | None | $77.62 | $87.10 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $147.91 | Professional | None | $77.62 | $91.20 | $147.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | None | $107.15 | $109.65 | $109.65 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $69.18 Typical High $70.79 | Facility | None | $64.57 | $69.18 | $70.79 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $131.83 | Professional | None | $60.26 | $70.79 | $131.83 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $138.04 | Professional | None | $77.62 | $100.00 | $138.04 |
1 more rate 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 $72.44 Median $72.44 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $72.44 | $72.44 | $91.20 |
Where Idaho sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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· 6th 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.