How much rates vary
Facilitymedian $35 · 10th to 90th $32 to $51Professionalmedian $35 · 10th to 90th $31 to $39
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 $38.02 Typical High $38.02 | Professional | None | $30.90 | $38.02 | $38.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $31.62 Median $35.48 Typical High $51.29 | Facility | None | $31.62 | $35.48 | $51.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $50.12 | Professional | None | $31.62 | $33.88 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $43.65 Typical High $77.62 | Facility | None | $42.66 | $43.65 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $38.02 Typical High $38.90 | Facility | None | $30.90 | $38.02 | $38.90 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $38.90 | Professional | None | $30.90 | $38.02 | $38.90 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $26.30 | Professional | None | $22.39 | $26.30 | $26.30 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $33.88 Median $35.48 Typical High $46.77 | Facility | None | $33.88 | $35.48 | $46.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $38.02 | Professional | None | $30.20 | $37.15 | $38.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $31.62 Median $44.67 Typical High $75.86 | Facility | None | $31.62 | $44.67 | $75.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $37.15 | Professional | None | $33.88 | $37.15 | $37.15 |
Select Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $64.57 | Facility | None | $30.90 | $30.90 | $64.57 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | None | $30.90 | $30.90 | $43.65 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
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 $15.49 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $6.17 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $4.68 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.80 | $3.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.38 Median $22.39 Typical High $23.99 | Professional | 78 · Unplanned return to OR | $21.38 | $22.39 | $23.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $16.98 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $6.76 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.39 | $3.89 | $3.89 |
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· 8th of 51
$34.67
AK $38.90CA $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.