How much rates vary
Facilitymedian $129 · 10th to 90th $95 to $214Professionalmedian $110 · 10th to 90th $62 to $145
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 $128.82 Typical High $128.82 | Professional | None | $102.33 | $128.82 | $128.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $97.72 Median $131.83 Typical High $223.87 | Facility | None | $97.72 | $131.83 | $223.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $141.25 | Professional | None | $60.26 | $70.79 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $186.21 | Facility | None | $125.89 | $128.82 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | None | $123.03 | $128.82 | $128.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $158.49 | Facility | None | $95.50 | $109.65 | $158.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $181.97 | Professional | None | $95.50 | $109.65 | $181.97 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $154.88 | Professional | None | $120.23 | $141.25 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $177.83 Typical High $251.19 | Facility | None | $154.88 | $177.83 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | None | $204.17 | $204.17 | $245.47 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $181.97 | Professional | None | $100.00 | $134.90 | $181.97 |
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 $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $51.29 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $12.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $48.98 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $41.69 | $48.98 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $24.55 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $12.88 |
Where Idaho sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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· 22nd of 51
$112
AK $251WY $75.86
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.