How much rates vary
Facilitymedian $36 · 10th to 90th $21 to $62Professionalmedian $32 · 10th to 90th $16 to $48
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 $25.12 Median $32.36 Typical High $32.36 | Professional | None | $25.12 | $32.36 | $32.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $29.51 Median $36.31 Typical High $61.66 | Facility | None | $29.51 | $36.31 | $61.66 |
BCBS Idaho Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $41.69 | Professional | None | $26.92 | $39.81 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $23.44 | Facility | None | $21.38 | $21.38 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
Moda Health Setting Facility Modifier None Typical Low $10.96 Median $32.36 Typical High $38.02 | Facility | None | $10.96 | $32.36 | $38.02 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $39.81 | Professional | None | $25.12 | $34.67 | $39.81 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $33.11 | Professional | None | $28.18 | $30.20 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $30.20 Median $47.86 Typical High $2,290.87 | Facility | None | $30.20 | $47.86 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $2,691.53 | Professional | None | $39.81 | $47.86 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $35.48 Median $36.31 Typical High $54.95 | Facility | None | $35.48 | $36.31 | $54.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | None | $26.92 | $26.92 | $39.81 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $48.98 | Facility | None | $38.02 | $38.02 | $48.98 |
Select Health Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $41.69 | Professional | None | $24.55 | $38.02 | $41.69 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $25.12 | Professional | None | $15.49 | $16.98 | $25.12 |
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 $12.59 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $12.59 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $5.01 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $3.80 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.51 | $3.24 | $3.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.12 Median $28.18 Typical High $29.51 | Professional | 78 · Unplanned return to OR | $25.12 | $28.18 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $12.59 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $5.01 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $3.80 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.51 | $3.24 | $3.24 |
Where Idaho sits
The same service costs 2.9 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· 13th of 51
$32.36
MT $40.74KS $14.13
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.