How much rates vary
Facilitymedian $48 · 10th to 90th $32 to $83Professionalmedian $42 · 10th to 90th $26 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 $30.20 Median $41.69 Typical High $41.69 | Professional | None | $30.20 | $41.69 | $41.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $83.18 | Facility | None | $39.81 | $47.86 | $83.18 |
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 $34.67 Median $34.67 Typical High $37.15 | Facility | None | $34.67 | $34.67 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $41.69 Typical High $50.12 | Facility | None | $14.13 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $52.48 | Professional | None | $32.36 | $41.69 | $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 $36.31 Median $63.10 Typical High $3,019.95 | Facility | None | $36.31 | $63.10 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $3,548.13 | Professional | None | $50.12 | $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 $46.77 Median $50.12 Typical High $79.43 | Facility | None | $46.77 | $50.12 | $79.43 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $54.95 | Professional | None | $33.11 | $50.12 | $54.95 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $38.02 | Professional | None | $20.42 | $21.88 | $38.02 |
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 $16.22 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $4.79 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
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 $16.22 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $4.79 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 14th of 51
$41.69
HI $77.62DC $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.