How much rates vary
Facilitymedian $151 · 10th to 90th $74 to $257Professionalmedian $138 · 10th to 90th $54 to $200
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 $102.33 Median $138.04 Typical High $138.04 | Professional | None | $102.33 | $138.04 | $138.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $257.04 | Facility | None | $125.89 | $151.36 | $257.04 |
BCBS Idaho Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $177.83 | Professional | None | $112.20 | $165.96 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $81.28 | Facility | None | $74.13 | $74.13 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $138.04 Typical High $158.49 | Facility | None | $38.02 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $165.96 | Professional | None | $104.71 | $144.54 | $165.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $120.23 Typical High $138.04 | Professional | None | $30.20 | $120.23 | $138.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $95.50 Median $199.53 Typical High $9,549.93 | Facility | None | $95.50 | $199.53 | $9,549.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $11,220.18 | Professional | None | $158.49 | $199.53 | $11,220.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $229.09 | Facility | None | $147.91 | $151.36 | $229.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $165.96 | Professional | None | $112.20 | $112.20 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $204.17 | Facility | None | $147.91 | $158.49 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | None | $104.71 | $158.49 | $158.49 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Facility | None | $77.62 | $77.62 | $79.43 |
United Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $87.10 | Professional | None | $53.70 | $58.88 | $87.10 |
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 $51.29 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $20.42 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.23 | $13.80 | $13.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $117.49 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $104.71 | $117.49 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $13.80 | $13.80 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 3rd of 51
$138
HI $170FL $54.95
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.