How much rates vary
Facilitymedian $209 · 10th to 90th $155 to $447Professionalmedian $162 · 10th to 90th $135 to $186
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 $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $501.19 | Facility | None | $204.17 | $281.84 | $501.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $354.81 | Professional | None | $162.18 | $165.96 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $380.19 | Facility | None | $208.93 | $208.93 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Facility | None | $147.91 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $186.21 | Professional | None | $147.91 | $169.82 | $186.21 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $204.17 | Facility | None | $154.88 | $162.18 | $204.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $186.21 | Professional | None | $154.88 | $165.96 | $186.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $478.63 | Facility | None | $173.78 | $251.19 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | None | $162.18 | $177.83 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $316.23 | Facility | None | $147.91 | $147.91 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
United Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | None | $134.90 | $134.90 | $144.54 |
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 $75.86 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $30.20 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.14 | $18.62 | $18.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $29.51 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $16.98 |
Where Idaho sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 4th of 51
$166
WY $355NY $148
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.