How much rates vary
Facilitymedian $48 · 10th to 90th $33 to $79Professionalmedian $44 · 10th to 90th $25 to $63
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 $33.11 Median $43.65 Typical High $43.65 | Professional | None | $33.11 | $43.65 | $43.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $36.31 Median $47.86 Typical High $79.43 | Facility | None | $36.31 | $47.86 | $79.43 |
BCBS Idaho Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $54.95 | Professional | None | $35.48 | $52.48 | $54.95 |
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 $14.45 Median $43.65 Typical High $50.12 | Facility | None | $14.45 | $43.65 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $52.48 | Professional | None | $33.11 | $45.71 | $52.48 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $42.66 | Professional | None | $30.20 | $36.31 | $42.66 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $39.81 Median $63.10 Typical High $3,019.95 | Facility | None | $39.81 | $63.10 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $3,548.13 | Professional | None | $52.48 | $63.10 | $3,548.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $46.77 Median $47.86 Typical High $72.44 | Facility | None | $46.77 | $47.86 | $72.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | None | $35.48 | $35.48 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $54.95 | Professional | None | $32.36 | $50.12 | $54.95 |
United Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $33.11 | Professional | None | $20.42 | $22.39 | $33.11 |
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 $16.60 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $4.37 | $4.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 78 · Unplanned return to OR | $33.11 | $37.15 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $16.60 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $4.37 | $4.37 |
Where Idaho sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 10th of 51
$43.65
MT $53.70AZ $24.55
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.