How much rates vary
Facilitymedian $32 · 10th to 90th $9 to $87Professionalmedian $16 · 10th to 90th $8 to $33
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 $8.32 Median $12.59 Typical High $16.22 | Professional | None | $8.32 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $6.03 Typical High $8.13 | Professional | 52 · Reduced service | $4.17 | $6.03 | $8.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $87.10 | Facility | None | $34.67 | $51.29 | $87.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $13.49 Median $21.38 Typical High $39.81 | Professional | None | $13.49 | $21.38 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Moda Health Setting Facility Modifier None Typical Low $8.32 Median $11.75 Typical High $19.05 | Facility | None | $8.32 | $11.75 | $19.05 |
Moda Health Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $30.90 | Professional | None | $8.32 | $15.14 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $6.03 Typical High $8.13 | Professional | 52 · Reduced service | $4.17 | $6.03 | $8.13 |
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 $8.51 Median $13.80 Typical High $30.20 | Facility | None | $8.51 | $13.80 | $30.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $16.22 Typical High $33.11 | Professional | None | $8.51 | $16.22 | $33.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $51.29 Median $74.13 Typical High $102.33 | Facility | None | $51.29 | $74.13 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.22 Median $17.38 Typical High $28.18 | Professional | None | $11.22 | $17.38 | $28.18 |
Select Health Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Facility | None | $17.38 | $17.38 | $17.78 |
Select Health Setting Professional Modifier None Typical Low $8.91 Median $16.60 Typical High $17.38 | Professional | None | $8.91 | $16.60 | $17.38 |
United Setting Professional Modifier None Typical Low $10.23 Median $17.78 Typical High $28.18 | Professional | None | $10.23 | $17.78 | $28.18 |
5 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 $11.22 Median $12.30 Typical High $26.30 | Professional | 78 · Unplanned return to OR | $11.22 | $12.30 | $26.30 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $6.31 Median $17.78 Typical High $32.36 | Professional | 59 · Distinct service | $6.31 | $17.78 | $32.36 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $11.22 Typical High $22.91 | Professional | 54 · Surgery only | $11.22 | $11.22 | $22.91 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $3.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.02 Median $12.02 Typical High $24.55 | Professional | 78 · Unplanned return to OR | $12.02 | $12.02 | $24.55 |
Where Idaho sits
The same service costs 2.3 times more in Alaska than in Louisiana. 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· 23rd of 51
$16.22
AK $30.90LA $13.49
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.