How much rates vary
Facilitymedian $38 · 10th to 90th $33 to $54Professionalmedian $36 · 10th to 90th $33 to $41
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | None | $33.11 | $40.74 | $40.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $33.88 Median $38.02 Typical High $53.70 | Facility | None | $33.88 | $38.02 | $53.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $53.70 | Professional | None | $33.11 | $36.31 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $83.18 | Facility | None | $45.71 | $46.77 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $74.13 | Facility | None | $34.67 | $40.74 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $40.74 | Professional | None | $33.11 | $38.90 | $40.74 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $25.12 | Professional | None | $21.38 | $25.12 | $25.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $47.86 | Facility | None | $36.31 | $36.31 | $47.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $40.74 | Professional | None | $30.90 | $37.15 | $40.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $28.84 Median $41.69 Typical High $70.79 | Facility | None | $28.84 | $41.69 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | None | $36.31 | $39.81 | $39.81 |
Select Health Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $69.18 | Facility | None | $33.11 | $33.11 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | None | $33.11 | $33.11 | $46.77 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | None | $30.90 | $30.90 | $33.11 |
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 $16.60 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.60 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.61 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.01 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.31 | $4.07 | $4.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $21.88 Median $25.12 Typical High $25.70 | Professional | 78 · Unplanned return to OR | $21.88 | $25.12 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $16.98 | $19.50 | $19.50 |
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 $5.13 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.13 | $5.89 | $5.89 |
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· 3rd of 51
$36.31
AK $41.69AZ $33.11
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.