How much rates vary
Facilitymedian $39 · 10th to 90th $23 to $65Professionalmedian $35 · 10th to 90th $17 to $51
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 $35.48 Typical High $35.48 | Professional | None | $27.54 | $35.48 | $35.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $32.36 Median $39.81 Typical High $66.07 | Facility | None | $32.36 | $39.81 | $66.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $45.71 | Professional | None | $28.84 | $43.65 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $25.12 | Facility | None | $22.91 | $22.91 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $35.48 Typical High $40.74 | Facility | None | $12.02 | $35.48 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | None | $27.54 | $37.15 | $43.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $35.48 | Professional | None | $30.20 | $30.90 | $35.48 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $33.11 Median $51.29 Typical High $2,454.71 | Facility | None | $33.11 | $51.29 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $2,884.03 | Professional | None | $40.74 | $51.29 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $58.88 | Facility | None | $38.02 | $39.81 | $58.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $43.65 | Professional | None | $28.84 | $28.84 | $43.65 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
Select Health Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $44.67 | Professional | None | $26.92 | $40.74 | $44.67 |
United Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $27.54 | Professional | None | $16.60 | $18.62 | $27.54 |
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 $13.49 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $13.49 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $5.50 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.07 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.69 | $3.55 | $3.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $30.20 Typical High $31.62 | Professional | 78 · Unplanned return to OR | $26.92 | $30.20 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $13.49 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $5.50 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.07 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.69 | $3.55 | $3.55 |
Where Idaho sits
The same service costs 2.6 times more in Montana than in Delaware. 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
$35.48
MT $43.65DE $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.