How much rates vary
Facilitymedian $20 · 10th to 90th $17 to $28Professionalmedian $19 · 10th to 90th $17 to $21
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 Facility Modifier None Typical Low $24.55 Median $25.70 Typical High $25.70 | Facility | None | $24.55 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | None | $17.38 | $21.38 | $21.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $17.38 Median $19.50 Typical High $28.18 | Facility | None | $17.38 | $19.50 | $28.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $28.18 | Professional | None | $17.38 | $19.05 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $24.55 Typical High $43.65 | Facility | None | $23.99 | $24.55 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $44.67 | Facility | None | $18.62 | $21.38 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | None | $17.38 | $21.38 | $21.38 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | None | $12.02 | $14.13 | $14.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $19.05 Median $19.50 Typical High $25.70 | Facility | None | $19.05 | $19.50 | $25.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $21.38 | Professional | None | $16.60 | $20.42 | $21.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $16.98 Median $23.99 Typical High $40.74 | Facility | None | $16.98 | $23.99 | $40.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | None | $19.05 | $20.42 | $20.42 |
Select Health Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $30.90 | Facility | None | $17.38 | $17.38 | $30.90 |
Select Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | None | $17.38 | $17.38 | $17.78 |
United Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | None | $16.98 | $16.98 | $18.20 |
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 $8.71 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $8.71 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.47 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.63 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.74 | $2.14 | $2.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11.22 Median $11.75 Typical High $13.18 | Professional | 78 · Unplanned return to OR | $11.22 | $11.75 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $9.33 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.72 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $2.75 | $3.16 | $3.16 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $2.14 |
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· 3rd of 51
$19.50
AK $21.88NC $16.98
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.