How much rates vary
Facilitymedian $54 · 10th to 90th $42 to $141Professionalmedian $46 · 10th to 90th $38 to $50
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 $38.90 Median $47.86 Typical High $47.86 | Professional | None | $38.90 | $47.86 | $47.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $158.49 | Facility | None | $50.12 | $112.20 | $158.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $52.48 | Professional | None | $41.69 | $45.71 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $97.72 | Facility | None | $53.70 | $53.70 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $50.12 | Facility | None | $38.02 | $47.86 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $50.12 | Professional | None | $38.02 | $47.86 | $50.12 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $60.26 | Facility | None | $41.69 | $45.71 | $60.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $47.86 | Professional | None | $38.90 | $47.86 | $47.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $47.86 | Professional | None | $41.69 | $45.71 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $109.65 | Facility | None | $38.02 | $38.02 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $44.67 | Professional | None | $39.81 | $39.81 | $44.67 |
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 $19.05 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $19.05 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.75 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.89 | $4.79 | $4.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $35.48 Typical High $37.15 | Professional | 78 · Unplanned return to OR | $28.18 | $35.48 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $5.01 | $5.01 |
Where Idaho sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 7th of 51
$45.71
AK $60.26SC $38.02
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.