How much rates vary
Facilitymedian $71 · 10th to 90th $42 to $117Professionalmedian $65 · 10th to 90th $31 to $93
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 $48.98 Median $64.57 Typical High $64.57 | Professional | None | $48.98 | $64.57 | $64.57 |
BCBS Idaho Setting Facility Modifier None Typical Low $57.54 Median $70.79 Typical High $117.49 | Facility | None | $57.54 | $70.79 | $117.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $81.28 | Professional | None | $52.48 | $77.62 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $44.67 | Facility | None | $41.69 | $41.69 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $64.57 Typical High $74.13 | Facility | None | $21.38 | $64.57 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $77.62 | Professional | None | $48.98 | $67.61 | $77.62 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $64.57 | Professional | None | $30.20 | $56.23 | $64.57 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $60.26 Median $93.33 Typical High $4,466.84 | Facility | None | $60.26 | $93.33 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $5,248.07 | Professional | None | $77.62 | $93.33 | $5,248.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $107.15 | Facility | None | $69.18 | $70.79 | $107.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | None | $52.48 | $52.48 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $95.50 | Facility | None | $74.13 | $74.13 | $95.50 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $81.28 | Professional | None | $48.98 | $74.13 | $81.28 |
United Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $50.12 | Professional | None | $30.20 | $33.11 | $50.12 |
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 $24.55 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $24.55 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $7.41 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.90 | $6.46 | $6.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $48.98 | $54.95 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $24.55 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $7.41 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.90 | $6.46 | $6.46 |
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
$64.57
MT $79.43DE $30.90
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.