How much rates vary
Facilitymedian $65 · 10th to 90th $47 to $107Professionalmedian $58 · 10th to 90th $33 to $85
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 $44.67 Median $57.54 Typical High $57.54 | Professional | None | $44.67 | $57.54 | $57.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $107.15 | Facility | None | $48.98 | $64.57 | $107.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $74.13 | Professional | None | $46.77 | $70.79 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $57.54 Typical High $67.61 | Facility | None | $21.38 | $57.54 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $70.79 | Professional | None | $44.67 | $60.26 | $70.79 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $58.88 | Professional | None | $30.20 | $50.12 | $58.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $4,073.80 | Facility | None | $53.70 | $85.11 | $4,073.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $4,786.30 | Professional | None | $67.61 | $85.11 | $4,786.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $97.72 | Facility | None | $63.10 | $64.57 | $97.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | None | $46.77 | $46.77 | $70.79 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $87.10 | Facility | None | $67.61 | $67.61 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $74.13 | Professional | None | $43.65 | $67.61 | $74.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
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 $22.39 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.91 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $6.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.47 | $5.75 | $5.75 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $44.67 | $50.12 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $22.39 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.91 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $6.76 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.47 | $5.75 | $5.75 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 14th of 51
$57.54
HI $123KY $39.81
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.