How much rates vary
Facilitymedian $91 · 10th to 90th $49 to $331Professionalmedian $76 · 10th to 90th $54 to $129
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 $48.98 Median $53.70 Typical High $60.26 | Professional | None | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $6.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $47.86 Median $120.23 Typical High $346.74 | Facility | None | $47.86 | $120.23 | $346.74 |
BCBS Idaho Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $138.04 | Professional | None | $95.50 | $128.82 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $53.70 Typical High $77.62 | Facility | None | $28.18 | $53.70 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $107.15 | Professional | None | $53.70 | $53.70 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $5.50 |
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 $66.07 Median $75.86 Typical High $107.15 | Facility | None | $66.07 | $75.86 | $107.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $125.89 | Professional | None | $66.07 | $75.86 | $125.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $97.72 | Facility | None | $47.86 | $70.79 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | None | $95.50 | $95.50 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $177.83 | Facility | None | $60.26 | $61.66 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $19.05 Median $63.10 Typical High $114.82 | Professional | None | $19.05 | $63.10 | $114.82 |
United Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $81.28 | Professional | None | $40.74 | $58.88 | $81.28 |
7 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 $24.55 Median $26.92 Typical High $30.20 | Professional | 52 · Reduced service | $24.55 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $12.02 | Professional | 53 · Discontinued | $10.00 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $9.12 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $9.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $24.55 | $26.92 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $11.22 | Professional | 53 · Discontinued | $10.00 | $10.96 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $8.32 |
Where Idaho sits
The same service costs 2.6 times more in Alaska 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· 7th of 51
$75.86
AK $105UT $39.81
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.