How much rates vary
Facilitymedian $174 · 10th to 90th $112 to $288Professionalmedian $155 · 10th to 90th $87 to $224
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 $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $141.25 Median $173.78 Typical High $288.40 | Facility | None | $141.25 | $173.78 | $288.40 |
BCBS Idaho Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $199.53 | Professional | None | $125.89 | $190.55 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Facility | None | $123.03 | $123.03 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $154.88 Typical High $181.97 | Facility | None | $56.23 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $190.55 | Professional | None | $120.23 | $154.88 | $190.55 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $128.82 Typical High $151.36 | Professional | None | $30.20 | $128.82 | $151.36 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $10,715.19 | Facility | None | $141.25 | $223.87 | $10,715.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $12,589.25 | Professional | None | $181.97 | $223.87 | $12,589.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $257.04 | Facility | None | $169.82 | $173.78 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $190.55 | Professional | None | $125.89 | $125.89 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $194.98 | Professional | None | $117.49 | $181.97 | $194.98 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $131.83 | Professional | None | $81.28 | $87.10 | $131.83 |
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 $58.88 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
Where Idaho sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 11th of 51
$155
HI $219AZ $89.13
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.