How much rates vary
Facilitymedian $32 · 10th to 90th $26 to $60Professionalmedian $30 · 10th to 90th $26 to $34
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 Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | None | $25.70 | $32.36 | $32.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $26.30 Median $34.67 Typical High $64.57 | Facility | None | $26.30 | $34.67 | $64.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $63.10 | Professional | None | $28.18 | $30.90 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $66.07 | Facility | None | $30.20 | $30.20 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $32.36 Typical High $38.90 | Facility | None | $28.18 | $32.36 | $38.90 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | None | $25.70 | $32.36 | $32.36 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $19.95 | Professional | None | $16.98 | $19.95 | $19.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $38.90 | Facility | None | $28.18 | $29.51 | $38.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $29.51 Median $30.90 Typical High $32.36 | Professional | None | $29.51 | $30.90 | $32.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.91 Median $38.02 Typical High $104.71 | Facility | None | $22.91 | $38.02 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | None | $28.18 | $30.90 | $32.36 |
Select Health Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $53.70 | Facility | None | $25.70 | $25.70 | $53.70 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | None | $25.70 | $25.70 | $26.30 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | None | $25.70 | $25.70 | $27.54 |
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 $13.18 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $13.18 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.25 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.89 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.63 | $3.24 | $3.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.05 Median $41.69 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $19.05 | $41.69 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $14.13 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.62 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.27 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.82 | $3.24 | $3.24 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 3rd of 51
$30.90
WY $36.31NC $25.12
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.