How much rates vary
Facilitymedian $69 · 10th to 90th $60 to $100Professionalmedian $66 · 10th to 90th $60 to $76
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 $60.26 Median $75.86 Typical High $75.86 | Professional | None | $60.26 | $75.86 | $75.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $100.00 | Facility | None | $60.26 | $67.61 | $100.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $97.72 | Professional | None | $63.10 | $66.07 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $154.88 | Facility | None | $85.11 | $85.11 | $154.88 |
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 $60.26 Median $75.86 Typical High $75.86 | Facility | None | $60.26 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | None | $60.26 | $70.79 | $75.86 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $85.11 | Facility | None | $64.57 | $66.07 | $85.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $75.86 | Professional | None | $54.95 | $67.61 | $75.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $125.89 | Facility | None | $52.48 | $74.13 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | None | $66.07 | $72.44 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $107.15 | Facility | None | $60.26 | $60.26 | $107.15 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
9 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 $30.20 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $30.20 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $12.30 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $9.12 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $7.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $44.67 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $42.66 | $44.67 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $30.90 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.30 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $9.12 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $7.08 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 2nd of 51
$66.07
AK $74.13OK $58.88
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.