How much rates vary
Facilitymedian $54 · 10th to 90th $33 to $91Professionalmedian $49 · 10th to 90th $24 to $71
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 $33.11 Median $48.98 Typical High $48.98 | Professional | None | $33.11 | $48.98 | $48.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $46.77 Median $53.70 Typical High $91.20 | Facility | None | $46.77 | $53.70 | $91.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $61.66 | Professional | None | $39.81 | $58.88 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $34.67 | Facility | None | $33.11 | $33.11 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $48.98 Typical High $56.23 | Facility | None | $16.22 | $48.98 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | None | $37.15 | $50.12 | $58.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $48.98 | Professional | None | $30.20 | $42.66 | $48.98 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $44.67 Median $70.79 Typical High $3,388.44 | Facility | None | $44.67 | $70.79 | $3,388.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $3,981.07 | Professional | None | $56.23 | $70.79 | $3,981.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $52.48 Median $53.70 Typical High $81.28 | Facility | None | $52.48 | $53.70 | $81.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $58.88 | Professional | None | $39.81 | $39.81 | $58.88 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Facility | None | $56.23 | $56.23 | $72.44 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $61.66 | Professional | None | $36.31 | $56.23 | $61.66 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $37.15 | Professional | None | $22.91 | $25.12 | $37.15 |
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 $18.62 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $18.62 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.41 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $5.62 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.72 | $4.79 | $4.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $41.69 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $37.15 | $41.69 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $18.62 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.41 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $5.62 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.72 | $4.90 | $4.90 |
Where Idaho sits
The same service costs 2.6 times more in Montana than in Kansas. 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
$48.98
MT $60.26KS $23.44
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.