How much rates vary
Facilitymedian $52 · 10th to 90th $38 to $87Professionalmedian $42 · 10th to 90th $37 to $47
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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | None | $38.02 | $46.77 | $46.77 |
BCBS Idaho Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $89.13 | Facility | None | $36.31 | $58.88 | $89.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $44.67 | Professional | None | $37.15 | $41.69 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $95.50 | Facility | None | $52.48 | $53.70 | $95.50 |
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 $40.74 Median $46.77 Typical High $56.23 | Facility | None | $40.74 | $46.77 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $46.77 | Professional | None | $38.02 | $45.71 | $46.77 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $30.90 | Professional | None | $26.30 | $30.20 | $30.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $56.23 | Facility | None | $41.69 | $42.66 | $56.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $46.77 | Professional | None | $36.31 | $43.65 | $46.77 |
Regence BlueShield Setting Facility Modifier None Typical Low $36.31 Median $52.48 Typical High $89.13 | Facility | None | $36.31 | $52.48 | $89.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $46.77 | Professional | None | $41.69 | $44.67 | $46.77 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $79.43 | Facility | None | $38.02 | $38.02 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | None | $37.15 | $37.15 | $38.90 |
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 $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $7.59 | $9.33 | $9.33 |
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 $3.80 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.80 | $4.68 | $4.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 78 · Unplanned return to OR | $24.55 | $27.54 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $19.95 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.03 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $4.57 | $4.57 |
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· 6th of 51
$41.69
AK $47.86HI $37.15
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.