How much rates vary
Facilitymedian $37 · 10th to 90th $28 to $71Professionalmedian $32 · 10th to 90th $25 to $36
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 $28.84 Median $36.31 Typical High $36.31 | Professional | None | $28.84 | $36.31 | $36.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $23.99 Median $39.81 Typical High $77.62 | Facility | None | $23.99 | $39.81 | $77.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $67.61 | Professional | None | $31.62 | $34.67 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $72.44 | Facility | None | $40.74 | $40.74 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $36.31 | Facility | None | $28.84 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $36.31 | Professional | None | $26.92 | $30.90 | $36.31 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | None | $17.38 | $20.42 | $20.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $28.18 Median $31.62 Typical High $37.15 | Facility | None | $28.18 | $31.62 | $37.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $36.31 | Professional | None | $24.55 | $29.51 | $36.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $29.51 Median $39.81 Typical High $87.10 | Facility | None | $29.51 | $39.81 | $87.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $36.31 | Professional | None | $31.62 | $34.67 | $36.31 |
Select Health Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $51.29 | Facility | None | $28.84 | $28.84 | $51.29 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $40.74 | Professional | None | $28.84 | $28.84 | $40.74 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | None | $24.55 | $24.55 | $28.84 |
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 $14.45 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $14.45 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.88 | $3.63 | $3.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.89 Median $22.39 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $20.89 | $22.39 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $13.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.37 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.07 | $4.68 | $4.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.69 | $3.09 | $3.09 |
Where Idaho sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 5th of 51
$31.62
WY $67.61AZ $24.55
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.