How much rates vary
Facilitymedian $479 · 10th to 90th $347 to $2,089Professionalmedian $229 · 10th to 90th $123 to $4,074
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 $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $794.33 Typical High $2,089.30 | Facility | None | $446.68 | $794.33 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $208.93 Median $977.24 Typical High $4,265.80 | Professional | None | $208.93 | $977.24 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $524.81 | Facility | None | $338.84 | $380.19 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $5,495.41 | Facility | None | $123.03 | $173.78 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $3,548.13 | Professional | None | $123.03 | $181.97 | $3,548.13 |
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 $181.97 Median $181.97 Typical High $3,162.28 | Facility | None | $181.97 | $181.97 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $32.36 Median $1,096.48 Typical High $1,096.48 | Professional | None | $32.36 | $1,096.48 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,238.72 | Facility | None | $1,122.02 | $1,584.89 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $977.24 Typical High $977.24 | Professional | None | $208.93 | $977.24 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Facility | None | $1,862.09 | $1,862.09 | $1,905.46 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $1,862.09 Typical High $2,630.27 | Professional | None | $138.04 | $1,862.09 | $2,630.27 |
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 $162.18 Median $208.93 Typical High $316.23 | Professional | None | $162.18 | $208.93 | $316.23 |
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 $61.66 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $15.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 52 · Reduced service | $61.66 | $61.66 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $24.55 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $13.80 |
Where Idaho sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 15th of 51
$407
TX $1,995MO $81.28
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.