How much rates vary
Facilitymedian $50 · 10th to 90th $44 to $72Professionalmedian $48 · 10th to 90th $43 to $55
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $54.95 | Professional | None | $43.65 | $54.95 | $54.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $72.44 | Facility | None | $43.65 | $50.12 | $72.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $70.79 | Professional | None | $43.65 | $47.86 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $109.65 | Facility | None | $61.66 | $61.66 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $54.95 Typical High $64.57 | Facility | None | $46.77 | $54.95 | $64.57 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $54.95 | Professional | None | $43.65 | $52.48 | $54.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | None | $30.20 | $30.20 | $35.48 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $63.10 | Facility | None | $47.86 | $47.86 | $63.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $54.95 | Professional | None | $41.69 | $50.12 | $54.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $41.69 Median $60.26 Typical High $102.33 | Facility | None | $41.69 | $60.26 | $102.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | None | $47.86 | $52.48 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $91.20 | Facility | None | $43.65 | $43.65 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
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 $21.88 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $21.88 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $8.71 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $6.61 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $5.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $29.51 Typical High $33.88 | Professional | 78 · Unplanned return to OR | $28.18 | $29.51 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.12 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $5.25 | $5.25 |
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· 4th of 51
$47.86
AK $54.95OR $43.65
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.