How much rates vary
Facilitymedian $115 · 10th to 90th $38 to $174Professionalmedian $74 · 10th to 90th $28 to $102
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 $74.13 Median $74.13 Typical High $83.18 | Professional | None | $74.13 | $74.13 | $83.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $181.97 | Facility | None | $104.71 | $123.03 | $181.97 |
BCBS Idaho Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Facility | None | $38.02 | $38.02 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $74.13 Typical High $83.18 | Facility | None | $40.74 | $74.13 | $83.18 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | None | $74.13 | $74.13 | $83.18 |
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 $83.18 Median $93.33 Typical High $134.90 | Facility | None | $83.18 | $93.33 | $134.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $158.49 | Professional | None | $83.18 | $93.33 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $131.83 Typical High $194.98 | Facility | None | $123.03 | $131.83 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $77.62 | Professional | None | $50.12 | $52.48 | $77.62 |
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 $37.15 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.32 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $67.61 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $60.26 | $67.61 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $37.15 | $37.15 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $14.79 | $14.79 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $8.32 |
Where Idaho sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 6th of 51
$83.18
ND $120HI $2.45
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.