How much rates vary
Facilitymedian $224 · 10th to 90th $191 to $363Professionalmedian $200 · 10th to 90th $105 to $8,511
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 $186.21 Median $199.53 Typical High $199.53 | Professional | None | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $19.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $363.08 | Facility | None | $177.83 | $218.78 | $363.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $281.84 | Facility | None | $186.21 | $199.53 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $239.88 | Professional | None | $186.21 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $93.33 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $19.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $44.67 | Professional | None | $30.20 | $38.02 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $13,803.84 | Facility | None | $288.40 | $288.40 | $13,803.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $57.54 Median $288.40 Typical High $16,218.10 | Professional | None | $57.54 | $288.40 | $16,218.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $331.13 | Facility | None | $213.80 | $218.78 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $295.12 | Facility | None | $229.09 | $229.09 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $457.09 | Professional | None | $223.87 | $229.09 | $457.09 |
United Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $112.20 | Professional | None | $89.13 | $107.15 | $112.20 |
4 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $177.83 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Idaho sits
The same service costs 2.5 times more in Alaska than in Utah. 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· 18th of 51
$200
AK $269UT $110
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.