How much rates vary
Facilitymedian $39 · 10th to 90th $19 to $72Professionalmedian $32 · 10th to 90th $15 to $32
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 $30.90 Median $31.62 Typical High $31.62 | Professional | None | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.57 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.09 | $3.16 | $3.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $22.39 Median $38.90 Typical High $72.44 | Facility | None | $22.39 | $38.90 | $72.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $44.67 Typical High $85.11 | Facility | None | $34.67 | $44.67 | $85.11 |
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 $14.79 Median $31.62 Typical High $45.71 | Facility | None | $14.79 | $31.62 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | None | $30.90 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.68 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | None | $23.99 | $28.18 | $28.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $19.95 | Facility | None | $15.14 | $15.14 | $19.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.88 Median $15.14 Typical High $15.49 | Professional | None | $12.88 | $15.14 | $15.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.20 Median $42.66 Typical High $79.43 | Facility | None | $30.20 | $42.66 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $61.66 | Facility | None | $38.02 | $43.65 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
1 more rate 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 $20.89 Median $21.88 Typical High $21.88 | Professional | 78 · Unplanned return to OR | $20.89 | $21.88 | $21.88 |
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· 43rd of 51
$31.62
AK $45.71AZ $30.90
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.