How much rates vary
Facilitymedian $55 · 10th to 90th $32 to $138Professionalmedian $37 · 10th to 90th $30 to $43
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 $34.67 Median $42.66 Typical High $42.66 | Professional | None | $34.67 | $42.66 | $42.66 |
BCBS Idaho Setting Facility Modifier None Typical Low $25.70 Median $70.79 Typical High $204.17 | Facility | None | $25.70 | $70.79 | $204.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $229.09 | Professional | None | $37.15 | $40.74 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $87.10 | Facility | None | $47.86 | $47.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $42.66 Typical High $42.66 | Facility | None | $33.88 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $42.66 | Professional | None | $31.62 | $35.48 | $42.66 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $42.66 | Facility | None | $32.36 | $37.15 | $42.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $42.66 | Professional | None | $28.18 | $33.88 | $42.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $81.28 Typical High $138.04 | Facility | None | $42.66 | $81.28 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $42.66 | Professional | None | $37.15 | $40.74 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $60.26 | Facility | None | $33.88 | $33.88 | $60.26 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | None | $33.88 | $33.88 | $48.98 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | None | $28.18 | $28.18 | $30.20 |
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 $17.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $17.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $6.92 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.13 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.47 | $4.27 | $4.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.12 Median $26.30 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $25.12 | $26.30 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $15.49 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.17 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.68 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.09 | $3.55 | $3.55 |
Where Idaho sits
The same service costs 5.4 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
$37.15
WY $162AZ $30.20
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.