How much rates vary
Facilitymedian $224 · 10th to 90th $151 to $380Professionalmedian $204 · 10th to 90th $107 to $295
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 $141.25 Median $204.17 Typical High $204.17 | Professional | None | $141.25 | $204.17 | $204.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $380.19 | Facility | None | $186.21 | $229.09 | $380.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $263.03 | Professional | None | $165.96 | $251.19 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $204.17 Typical High $239.88 | Facility | None | $69.18 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $251.19 | Professional | None | $158.49 | $204.17 | $251.19 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $173.78 Typical High $204.17 | Professional | None | $30.20 | $173.78 | $204.17 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $14,125.38 | Facility | None | $190.55 | $295.12 | $14,125.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $16,595.87 | Professional | None | $239.88 | $295.12 | $16,595.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $338.84 | Facility | None | $223.87 | $229.09 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | None | $165.96 | $165.96 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $302.00 | Facility | None | $239.88 | $239.88 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $263.03 | Professional | None | $154.88 | $239.88 | $263.03 |
United Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $158.49 | Professional | None | $97.72 | $107.15 | $158.49 |
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 $79.43 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $20.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $20.42 |
Where Idaho sits
The same service costs 2.1 times more in Hawaii than in Utah. 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
$204
HI $240UT $112
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.