How much rates vary
Facilitymedian $95 · 10th to 90th $62 to $158Professionalmedian $87 · 10th to 90th $45 to $126
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 $66.07 Median $87.10 Typical High $87.10 | Professional | None | $66.07 | $87.10 | $87.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $158.49 | Facility | None | $77.62 | $95.50 | $158.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $109.65 | Professional | None | $70.79 | $104.71 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $87.10 Typical High $100.00 | Facility | None | $31.62 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $104.71 | Professional | None | $66.07 | $91.20 | $104.71 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $75.86 Typical High $87.10 | Professional | None | $30.20 | $75.86 | $87.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $6,025.60 | Facility | None | $79.43 | $125.89 | $6,025.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $7,079.46 | Professional | None | $100.00 | $125.89 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $144.54 | Facility | None | $93.33 | $95.50 | $144.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $104.71 | Professional | None | $70.79 | $70.79 | $104.71 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $128.82 | Facility | None | $100.00 | $100.00 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $109.65 | Professional | None | $64.57 | $100.00 | $109.65 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $48.98 | Facility | None | $29.51 | $29.51 | $48.98 |
United Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $72.44 | Professional | None | $44.67 | $48.98 | $72.44 |
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 $33.11 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $8.71 | $8.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $66.07 | $74.13 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $8.71 | $8.71 |
Where Idaho sits
The same service costs 2.4 times more in Montana than in Delaware. 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· 12th of 51
$87.10
MT $107DE $44.67
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.