How much rates vary
Facilitymedian $178 · 10th to 90th $89 to $302Professionalmedian $162 · 10th to 90th $66 to $234
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 $125.89 Median $162.18 Typical High $162.18 | Professional | None | $125.89 | $162.18 | $162.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $302.00 | Facility | None | $134.90 | $181.97 | $302.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $208.93 | Professional | None | $131.83 | $199.53 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Facility | None | $89.13 | $89.13 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $162.18 Typical High $177.83 | Facility | None | $44.67 | $162.18 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $199.53 | Professional | None | $125.89 | $169.82 | $199.53 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $141.25 Typical High $162.18 | Professional | None | $30.20 | $141.25 | $162.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $11,220.18 | Facility | None | $120.23 | $234.42 | $11,220.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $13,182.57 | Professional | None | $190.55 | $234.42 | $13,182.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $177.83 Median $181.97 Typical High $269.15 | Facility | None | $177.83 | $181.97 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $199.53 | Professional | None | $131.83 | $131.83 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $239.88 | Facility | None | $173.78 | $190.55 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $199.53 | Professional | None | $123.03 | $190.55 | $199.53 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $102.33 | Professional | None | $64.57 | $69.18 | $102.33 |
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 $61.66 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $16.22 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $138.04 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $123.03 | $138.04 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $61.66 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $16.22 |
Where Idaho sits
The same service costs 5.1 times more in Hawaii 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· 3rd of 51
$162
HI $339DE $66.07
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.