How much rates vary
Facilitymedian $49 · 10th to 90th $35 to $81Professionalmedian $45 · 10th to 90th $26 to $65
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 $30.90 Median $44.67 Typical High $44.67 | Professional | None | $30.90 | $44.67 | $44.67 |
BCBS Idaho Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $81.28 | Facility | None | $40.74 | $50.12 | $81.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $57.54 | Professional | None | $36.31 | $54.95 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $44.67 Typical High $51.29 | Facility | None | $15.14 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $54.95 | Professional | None | $34.67 | $44.67 | $54.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $44.67 | Professional | None | $30.20 | $38.90 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $3,090.30 | Facility | None | $41.69 | $64.57 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $3,630.78 | Professional | None | $51.29 | $64.57 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $74.13 | Facility | None | $47.86 | $50.12 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $54.95 | Professional | None | $36.31 | $36.31 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $66.07 | Facility | None | $51.29 | $51.29 | $66.07 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $56.23 | Professional | None | $33.88 | $51.29 | $56.23 |
United Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $34.67 | Professional | None | $20.89 | $23.44 | $34.67 |
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 $16.98 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $16.98 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $6.92 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.13 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.47 | $4.47 | $4.47 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $38.02 Typical High $39.81 | Professional | 78 · Unplanned return to OR | $33.88 | $38.02 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $16.98 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $6.92 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $5.13 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.47 | $4.47 | $4.47 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$44.67
MT $54.95NJ $25.70
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.