How much rates vary
Facilitymedian $79 · 10th to 90th $49 to $132Professionalmedian $71 · 10th to 90th $30 to $102
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 $47.86 Median $70.79 Typical High $70.79 | Professional | None | $47.86 | $70.79 | $70.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $79.43 Typical High $131.83 | Facility | None | $64.57 | $79.43 | $131.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $91.20 | Professional | None | $57.54 | $87.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $51.29 | Facility | None | $48.98 | $48.98 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $19.50 Median $70.79 Typical High $83.18 | Facility | None | $19.50 | $70.79 | $83.18 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $87.10 | Professional | None | $54.95 | $70.79 | $87.10 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $70.79 | Professional | None | $30.20 | $61.66 | $70.79 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $53.70 Median $102.33 Typical High $4,897.79 | Facility | None | $53.70 | $102.33 | $4,897.79 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $5,754.40 | Professional | None | $83.18 | $102.33 | $5,754.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $117.49 | Facility | None | $77.62 | $79.43 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | None | $57.54 | $57.54 | $87.10 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $104.71 | Facility | None | $75.86 | $83.18 | $104.71 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $87.10 | Professional | None | $53.70 | $83.18 | $87.10 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $44.67 | Professional | None | $28.18 | $30.20 | $44.67 |
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 $26.92 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $10.96 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $8.13 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $7.08 | $7.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $60.26 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $53.70 | $60.26 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $10.96 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $8.13 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $7.08 | $7.08 |
Where Idaho sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 3rd of 51
$70.79
HI $132DC $33.11
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.