How much rates vary
Facilitymedian $191 · 10th to 90th $120 to $324Professionalmedian $170 · 10th to 90th $85 to $251
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 $131.83 Median $169.82 Typical High $169.82 | Professional | None | $131.83 | $169.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $323.59 | Facility | None | $154.88 | $190.55 | $323.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $218.78 | Professional | None | $138.04 | $208.93 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $169.82 Typical High $199.53 | Facility | None | $54.95 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $208.93 | Professional | None | $131.83 | $177.83 | $208.93 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $147.91 Typical High $169.82 | Professional | None | $30.20 | $147.91 | $169.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $12,022.64 | Facility | None | $158.49 | $251.19 | $12,022.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $14,125.38 | Professional | None | $199.53 | $251.19 | $14,125.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $288.40 | Facility | None | $186.21 | $190.55 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $208.93 | Professional | None | $138.04 | $138.04 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $257.04 | Facility | None | $199.53 | $199.53 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $218.78 | Professional | None | $128.82 | $199.53 | $218.78 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
United Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $125.89 | Professional | None | $77.62 | $85.11 | $125.89 |
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 $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $16.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $16.98 |
Where Idaho sits
The same service costs 2.4 times more in Montana 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· 11th of 51
$170
MT $209VT $87.10
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.