How much rates vary
Facilitymedian $71 · 10th to 90th $46 to $107Professionalmedian $50 · 10th to 90th $31 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 $45.71 Median $45.71 Typical High $51.29 | Professional | None | $45.71 | $45.71 | $51.29 |
BCBS Idaho Setting Facility Modifier None Typical Low $64.57 Median $77.62 Typical High $112.20 | Facility | None | $64.57 | $77.62 | $112.20 |
BCBS Idaho Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | None | $60.26 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Facility | None | $50.12 | $50.12 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $51.29 | Facility | None | $25.12 | $45.71 | $51.29 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | None | $45.71 | $45.71 | $51.29 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $51.29 Median $58.88 Typical High $83.18 | Facility | None | $51.29 | $58.88 | $83.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $97.72 | Professional | None | $51.29 | $58.88 | $97.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $75.86 Median $81.28 Typical High $120.23 | Facility | None | $75.86 | $81.28 | $120.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $48.98 | Professional | None | $30.90 | $33.11 | $48.98 |
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 $22.91 Median $22.91 Typical High $25.70 | Professional | 52 · Reduced service | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.76 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $42.66 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $38.02 | $42.66 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | 52 · Reduced service | $22.91 | $22.91 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.76 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.13 |
Where Idaho sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 8th of 51
$51.29
KS $135CO $33.11
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.