How much rates vary
Facilitymedian $85 · 10th to 90th $59 to $145Professionalmedian $76 · 10th to 90th $44 to $112
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 $75.86 Typical High $75.86 | Professional | None | $58.88 | $75.86 | $75.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $144.54 | Facility | None | $69.18 | $85.11 | $144.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $97.72 | Professional | None | $61.66 | $93.33 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $75.86 Typical High $89.13 | Facility | None | $28.18 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $93.33 | Professional | None | $58.88 | $79.43 | $93.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $75.86 | Professional | None | $30.20 | $64.57 | $75.86 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $112.20 Typical High $5,370.32 | Facility | None | $70.79 | $112.20 | $5,370.32 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $6,309.57 | Professional | None | $93.33 | $112.20 | $6,309.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $128.82 | Facility | None | $83.18 | $85.11 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Professional | None | $61.66 | $61.66 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $114.82 | Facility | None | $89.13 | $89.13 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $97.72 | Professional | None | $57.54 | $89.13 | $97.72 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $64.57 | Professional | None | $39.81 | $43.65 | $64.57 |
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 $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $29.51 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $11.75 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.89 | $7.59 | $7.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $58.88 | $66.07 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $29.51 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $11.75 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.89 | $7.59 | $7.59 |
Where Idaho sits
The same service costs 3.5 times more in Hawaii than in New Jersey. 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· 13th of 51
$75.86
HI $166NJ $46.77
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.