How much rates vary
Facilitymedian $110 · 10th to 90th $71 to $182Professionalmedian $100 · 10th to 90th $51 to $182
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 $75.86 Median $100.00 Typical High $100.00 | Professional | None | $75.86 | $100.00 | $100.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $181.97 | Facility | None | $97.72 | $109.65 | $181.97 |
BCBS Idaho Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $125.89 | Professional | None | $81.28 | $120.23 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $114.82 | Facility | None | $75.86 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | None | $75.86 | $100.00 | $100.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $6,918.31 | Facility | None | $114.82 | $144.54 | $6,918.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $8,128.31 | Professional | None | $114.82 | $144.54 | $8,128.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $165.96 | Facility | None | $107.15 | $109.65 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $120.23 | Professional | None | $81.28 | $81.28 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Facility | None | $114.82 | $114.82 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $125.89 | Professional | None | $74.13 | $114.82 | $125.89 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $63.10 | Professional | None | $48.98 | $51.29 | $63.10 |
8 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 $38.02 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $10.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $85.11 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $75.86 | $85.11 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $10.00 |
Where Idaho sits
The same service costs 2.4 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· 13th of 51
$100
MT $123DE $51.29
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.