How much rates vary
Facilitymedian $91 · 10th to 90th $50 to $155Professionalmedian $79 · 10th to 90th $37 to $120
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 $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
BCBS Idaho Setting Facility Modifier None Typical Low $74.13 Median $91.20 Typical High $154.88 | Facility | None | $74.13 | $91.20 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $104.71 | Professional | None | $66.07 | $100.00 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Facility | None | $50.12 | $50.12 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $79.43 Typical High $95.50 | Facility | None | $25.12 | $79.43 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $100.00 | Professional | None | $60.26 | $85.11 | $100.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $81.28 | Professional | None | $30.20 | $69.18 | $81.28 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $63.10 Median $120.23 Typical High $5,754.40 | Facility | None | $63.10 | $120.23 | $5,754.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $6,760.83 | Professional | None | $95.50 | $120.23 | $6,760.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $138.04 | Facility | None | $89.13 | $91.20 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $100.00 | Professional | None | $66.07 | $66.07 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $95.50 Typical High $123.03 | Facility | None | $89.13 | $95.50 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $102.33 | Professional | None | $61.66 | $95.50 | $102.33 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Facility | None | $32.36 | $32.36 | $38.90 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $60.26 | Professional | None | $36.31 | $38.90 | $60.26 |
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 $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $12.02 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $7.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $12.02 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $7.94 |
Where Idaho sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 6th of 51
$79.43
AR $85.11CO $39.81
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.