How much rates vary
Facilitymedian $69 · 10th to 90th $60 to $98Professionalmedian $66 · 10th to 90th $59 to $74
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 $58.88 Median $72.44 Typical High $72.44 | Professional | None | $58.88 | $72.44 | $72.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $95.50 | Facility | None | $60.26 | $67.61 | $95.50 |
BCBS Idaho Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $95.50 | Professional | None | $60.26 | $66.07 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $147.91 | Facility | None | $81.28 | $83.18 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $74.13 | Facility | None | $58.88 | $72.44 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $74.13 | Professional | None | $58.88 | $72.44 | $74.13 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $69.18 Typical High $91.20 | Facility | None | $64.57 | $69.18 | $91.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $72.44 | Professional | None | $58.88 | $70.79 | $72.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $165.96 | Facility | None | $64.57 | $97.72 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $70.79 | Professional | None | $64.57 | $70.79 | $70.79 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $123.03 | Facility | None | $58.88 | $58.88 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | None | $58.88 | $58.88 | $83.18 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
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 $29.51 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $29.51 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.75 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.91 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $7.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $44.67 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $42.66 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $32.36 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.18 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.46 | $7.41 | $7.41 |
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
$66.07
AK $79.43GA $58.88
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.