How much rates vary
Facilitymedian $47 · 10th to 90th $32 to $78Professionalmedian $42 · 10th to 90th $25 to $62
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 $32.36 Median $41.69 Typical High $41.69 | Professional | None | $32.36 | $41.69 | $41.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $77.62 | Facility | None | $34.67 | $46.77 | $77.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $53.70 | Professional | None | $33.88 | $51.29 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Facility | None | $33.88 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $41.69 Typical High $48.98 | Facility | None | $14.13 | $41.69 | $48.98 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $51.29 | Professional | None | $32.36 | $43.65 | $51.29 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $41.69 | Professional | None | $30.20 | $36.31 | $41.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $38.90 Median $61.66 Typical High $2,951.21 | Facility | None | $38.90 | $61.66 | $2,951.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $3,467.37 | Professional | None | $48.98 | $61.66 | $3,467.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $70.79 | Facility | None | $45.71 | $46.77 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | None | $33.88 | $33.88 | $51.29 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Facility | None | $48.98 | $48.98 | $63.10 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $53.70 | Professional | None | $31.62 | $48.98 | $53.70 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $32.36 | Professional | None | $20.42 | $21.88 | $32.36 |
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 $16.22 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $4.79 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $35.48 Typical High $38.02 | Professional | 78 · Unplanned return to OR | $31.62 | $35.48 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $4.90 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
Where Idaho sits
The same service costs 3.1 times more in Montana than in Kansas. 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
$41.69
MT $52.48KS $16.98
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.