How much rates vary
Facilitymedian $45 · 10th to 90th $28 to $65Professionalmedian $35 · 10th to 90th $19 to $40
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 $27.54 Median $27.54 Typical High $30.20 | Professional | None | $27.54 | $27.54 | $30.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $38.90 Median $45.71 Typical High $67.61 | Facility | None | $38.90 | $45.71 | $67.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | None | $36.31 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Facility | None | $54.95 | $54.95 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $27.54 Typical High $30.20 | Facility | None | $15.14 | $27.54 | $30.20 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | None | $27.54 | $27.54 | $30.20 |
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 $30.20 Median $34.67 Typical High $50.12 | Facility | None | $30.20 | $34.67 | $50.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $58.88 | Professional | None | $30.20 | $34.67 | $58.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $44.67 Median $48.98 Typical High $72.44 | Facility | None | $44.67 | $48.98 | $72.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $28.84 | Professional | None | $18.20 | $19.50 | $28.84 |
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 $13.80 Median $13.80 Typical High $15.14 | Professional | 52 · Reduced service | $13.80 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | 53 · Discontinued | $5.50 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.57 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $25.12 Typical High $26.92 | Professional | 78 · Unplanned return to OR | $22.91 | $25.12 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | 52 · Reduced service | $13.80 | $13.80 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | 53 · Discontinued | $5.50 | $5.50 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.57 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.02 |
Where Idaho sits
The same service costs 8.9 times more in North Dakota 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· 28th of 51
$34.67
ND $174CO $19.50
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.