How much rates vary
Facilitymedian $71 · 10th to 90th $56 to $120Professionalmedian $62 · 10th to 90th $54 to $71
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 $57.54 Median $70.79 Typical High $70.79 | Professional | None | $57.54 | $70.79 | $70.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $123.03 | Facility | None | $50.12 | $75.86 | $123.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | None | $58.88 | $63.10 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $144.54 | Facility | None | $79.43 | $79.43 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $70.79 | Facility | None | $56.23 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | None | $56.23 | $66.07 | $70.79 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | None | $36.31 | $36.31 | $42.66 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $81.28 | Facility | None | $61.66 | $61.66 | $81.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | None | $52.48 | $63.10 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $50.12 Median $72.44 Typical High $123.03 | Facility | None | $50.12 | $72.44 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $70.79 | Professional | None | $61.66 | $67.61 | $70.79 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $117.49 | Facility | None | $56.23 | $56.23 | $117.49 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | None | $56.23 | $56.23 | $79.43 |
United Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | None | $53.70 | $53.70 | $56.23 |
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 $28.18 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $11.48 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.75 | $7.08 | $7.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $41.69 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $38.90 | $41.69 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $28.84 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $11.48 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.71 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.75 | $6.61 | $6.61 |
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· 2nd of 51
$63.10
AK $69.18AL $56.23
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.