How much rates vary
Facilitymedian $380 · 10th to 90th $170 to $603Professionalmedian $347 · 10th to 90th $257 to $407
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 $234.42 Median $309.03 Typical High $331.13 | Professional | None | $234.42 | $309.03 | $331.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $660.69 | Facility | None | $323.59 | $407.38 | $660.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $457.09 | Professional | None | $338.84 | $380.19 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $363.08 | Professional | None | $257.04 | $316.23 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $446.68 | Facility | None | $199.53 | $309.03 | $446.68 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $407.38 | Professional | None | $309.03 | $354.81 | $407.38 |
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 $346.74 Median $389.05 Typical High $389.05 | Facility | None | $346.74 | $389.05 | $389.05 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | None | $346.74 | $389.05 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $660.69 | Facility | None | $346.74 | $501.19 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $363.08 | Professional | None | $194.98 | $263.03 | $363.08 |
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 $154.88 Median $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $31.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where Idaho sits
The same service costs 3.0 times more in Wisconsin 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· 11th of 51
$347
WI $537FL $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.