How much rates vary
Facilitymedian $186 · 10th to 90th $112 to $316Professionalmedian $170 · 10th to 90th $83 to $245
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 $114.82 Median $169.82 Typical High $169.82 | Professional | None | $114.82 | $169.82 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $162.18 Median $190.55 Typical High $316.23 | Facility | None | $162.18 | $190.55 | $316.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $218.78 | Professional | None | $138.04 | $208.93 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $123.03 | Facility | None | $112.20 | $112.20 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $169.82 Typical High $199.53 | Facility | None | $57.54 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $208.93 | Professional | None | $131.83 | $169.82 | $208.93 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $144.54 Typical High $169.82 | Professional | None | $30.20 | $144.54 | $169.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $11,748.98 | Facility | None | $158.49 | $245.47 | $11,748.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $13,803.84 | Professional | None | $199.53 | $245.47 | $13,803.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $281.84 | Facility | None | $186.21 | $190.55 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $208.93 | Professional | None | $138.04 | $138.04 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Facility | None | $199.53 | $199.53 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $218.78 | Professional | None | $128.82 | $199.53 | $218.78 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $134.90 | Professional | None | $83.18 | $89.13 | $134.90 |
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 $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.50 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $16.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $144.54 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $128.82 | $144.54 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.50 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $16.98 |
Where Idaho sits
The same service costs 2.3 times more in Hawaii 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
$170
HI $200DE $85.11
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.