How much rates vary
Facilitymedian $501 · 10th to 90th $339 to $1,905Professionalmedian $324 · 10th to 90th $224 to $427
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | None | $275.42 | $275.42 | $338.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,905.46 | Facility | None | $457.09 | $457.09 | $1,905.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $389.05 | Professional | None | $288.40 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $676.08 | Facility | None | $446.68 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $7,079.46 | Facility | None | $275.42 | $338.84 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $1,000.00 Typical High $1,000.00 | Professional | None | $346.74 | $1,000.00 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,445.44 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | None | $371.54 | $389.05 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Facility | None | $331.13 | $331.13 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $537.03 | Professional | None | $169.82 | $275.42 | $537.03 |
11 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 $138.04 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $30.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $138.04 | $138.04 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $204.17 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $30.90 |
Where Idaho sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 35th of 51
$363
OK $1,514RI $182
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.