How much rates vary
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 $26.30 Median $28.84 Typical High $33.11 | Professional | None | $26.30 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $14.13 | $14.45 |
BCBS Idaho Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $74.13 | Professional | None | $46.77 | $56.23 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $28.84 Typical High $40.74 | Facility | None | $28.18 | $28.84 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $56.23 | Professional | None | $26.92 | $28.84 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $14.13 | $14.45 |
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 $39.81 Typical High $54.95 | Facility | None | $28.84 | $39.81 | $54.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $57.54 | Professional | None | $28.84 | $36.31 | $57.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $50.12 | Professional | None | $38.02 | $46.77 | $50.12 |
Select Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Facility | None | $32.36 | $32.36 | $33.11 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $56.23 | Professional | None | $29.51 | $33.11 | $56.23 |
United Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $56.23 | Professional | None | $31.62 | $40.74 | $56.23 |
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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $41.69 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $35.48 | $41.69 | $51.29 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 54 · Surgery only | $38.02 | $38.02 | $39.81 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.75 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $40.74 | $40.74 | $42.66 |
Where Idaho sits
The same service costs 3.1 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· 14th of 51
$40.74
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.