How much rates vary
Facilitymedian $537 · 10th to 90th $240 to $1,023Professionalmedian $251 · 10th to 90th $200 to $355
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 $204.17 Median $239.88 Typical High $245.47 | Professional | None | $204.17 | $239.88 | $245.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $302.00 Median $537.03 Typical High $1,023.29 | Facility | None | $302.00 | $537.03 | $1,023.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $363.08 | Professional | None | $251.19 | $309.03 | $363.08 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $239.88 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $302.00 | Professional | None | $199.53 | $251.19 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $338.84 | Facility | None | $239.88 | $239.88 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | None | $239.88 | $239.88 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Facility | None | $269.15 | $302.00 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $309.03 | Professional | None | $257.04 | $302.00 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $1,096.48 | Facility | None | $602.56 | $870.96 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $295.12 | Professional | None | $213.80 | $251.19 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $562.34 | Facility | None | $158.49 | $162.18 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $281.84 | Professional | None | $158.49 | $158.49 | $281.84 |
United Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $323.59 | Professional | None | $181.97 | $245.47 | $323.59 |
12 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 $102.33 Median $120.23 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 52 · Reduced service | $120.23 | $120.23 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 53 · Discontinued | $47.86 | $47.86 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $24.55 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 22 · Increased work | $281.84 | $281.84 | $281.84 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $177.83 | $177.83 | $177.83 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 63 · Small infant | $281.84 | $281.84 | $281.84 |
Where Idaho sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 17th of 51
$257
AK $447FL $155
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.