How much rates vary
Facilitymedian $33 · 10th to 90th $24 to $56Professionalmedian $30 · 10th to 90th $18 to $44
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 $23.44 Median $30.20 Typical High $30.20 | Professional | None | $23.44 | $30.20 | $30.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $56.23 | Facility | None | $27.54 | $33.88 | $56.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $38.90 | Professional | None | $24.55 | $37.15 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Facility | None | $24.55 | $24.55 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Moda Health Setting Facility Modifier None Typical Low $10.23 Median $30.20 Typical High $35.48 | Facility | None | $10.23 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $23.44 Median $31.62 Typical High $37.15 | Professional | None | $23.44 | $31.62 | $37.15 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $30.20 | Professional | None | $25.70 | $29.51 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $2,089.30 | Facility | None | $28.18 | $43.65 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $2,454.71 | Professional | None | $37.15 | $43.65 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $33.11 Median $33.88 Typical High $50.12 | Facility | None | $33.11 | $33.88 | $50.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $37.15 | Professional | None | $24.55 | $24.55 | $37.15 |
Select Health Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $44.67 | Facility | None | $35.48 | $35.48 | $44.67 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $38.02 | Professional | None | $22.91 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $23.44 | Professional | None | $14.13 | $15.85 | $23.44 |
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 $11.48 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $11.48 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $4.68 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.29 | $3.02 | $3.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $25.70 Typical High $26.92 | Professional | 78 · Unplanned return to OR | $22.91 | $25.70 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $11.48 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $4.68 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $3.47 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.34 | $3.02 | $3.02 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$30.20
MT $37.15WV $17.78
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.