How much rates vary
Facilitymedian $83 · 10th to 90th $60 to $141Professionalmedian $72 · 10th to 90th $39 to $110
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 $56.23 Median $72.44 Typical High $72.44 | Professional | None | $56.23 | $72.44 | $72.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $141.25 | Facility | None | $67.61 | $83.18 | $141.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $95.50 | Professional | None | $61.66 | $91.20 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $72.44 Typical High $87.10 | Facility | None | $25.12 | $72.44 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $91.20 | Professional | None | $56.23 | $79.43 | $91.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $63.10 Typical High $74.13 | Professional | None | $30.20 | $63.10 | $74.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $5,248.07 | Facility | None | $69.18 | $109.65 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $6,165.95 | Professional | None | $87.10 | $109.65 | $6,165.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $125.89 | Facility | None | $81.28 | $83.18 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $91.20 | Professional | None | $61.66 | $61.66 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $112.20 | Facility | None | $87.10 | $87.10 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | None | $56.23 | $87.10 | $95.50 |
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 $27.54 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $7.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $64.57 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $57.54 | $64.57 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $7.24 |
Where Idaho sits
The same service costs 2.0 times more in Montana than in South Carolina. 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
$74.13
MT $93.33SC $46.77
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.