How much rates vary
Facilitymedian $107 · 10th to 90th $60 to $178Professionalmedian $95 · 10th to 90th $44 to $138
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 $74.13 Median $95.50 Typical High $95.50 | Professional | None | $74.13 | $95.50 | $95.50 |
BCBS Idaho Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $177.83 | Facility | None | $87.10 | $107.15 | $177.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $123.03 | Professional | None | $77.62 | $117.49 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $95.50 Typical High $109.65 | Facility | None | $28.18 | $95.50 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $117.49 | Professional | None | $74.13 | $100.00 | $117.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $93.33 | Professional | None | $30.20 | $79.43 | $93.33 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $138.04 Typical High $6,606.93 | Facility | None | $70.79 | $138.04 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $7,762.47 | Professional | None | $109.65 | $138.04 | $7,762.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $158.49 | Facility | None | $102.33 | $107.15 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | None | $77.62 | $77.62 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $109.65 Typical High $141.25 | Facility | None | $102.33 | $109.65 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $117.49 | Professional | None | $72.44 | $109.65 | $117.49 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
United Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $66.07 | Professional | None | $40.74 | $43.65 | $66.07 |
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 $36.31 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $36.31 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $14.79 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $10.96 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $9.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $81.28 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $72.44 | $81.28 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $36.31 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $14.79 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $10.96 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $9.55 |
Where Idaho sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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· 6th of 51
$95.50
HI $166VT $48.98
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.