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 $21.38 Median $23.99 Typical High $24.55 | Professional | None | $21.38 | $23.99 | $24.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $39.81 Median $40.74 Typical High $64.57 | Facility | None | $39.81 | $40.74 | $64.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $58.88 | Professional | None | $40.74 | $50.12 | $58.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $39.81 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $33.88 | $39.81 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $32.36 | Facility | None | $23.99 | $23.99 | $32.36 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $47.86 | Professional | None | $21.38 | $23.99 | $47.86 |
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 $28.84 Median $32.36 Typical High $46.77 | Facility | None | $28.84 | $32.36 | $46.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $54.95 | Professional | None | $28.84 | $32.36 | $54.95 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $36.31 | $36.31 | $36.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $64.57 | Facility | None | $39.81 | $42.66 | $64.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | None | $33.88 | $40.74 | $40.74 |
Select Health Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.92 | Facility | None | $26.30 | $26.30 | $26.92 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $37.15 Typical High $47.86 | Professional | None | $26.30 | $37.15 | $47.86 |
United Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $43.65 | Professional | None | $26.92 | $33.11 | $43.65 |
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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 22 · Increased work | $52.48 | $52.48 | $52.48 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 54 · Surgery only | $33.88 | $33.88 | $33.88 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 63 · Small infant | $52.48 | $52.48 | $52.48 |
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· 12th of 51
$33.88
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.