How much rates vary
Facilitymedian $1,122 · 10th to 90th $120 to $5,495Professionalmedian $275 · 10th to 90th $102 to $1,148
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 $660.69 Typical High $707.95 | Professional | None | $234.42 | $660.69 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $72.44 Median $2,691.53 Typical High $5,495.41 | Facility | None | $72.44 | $2,691.53 | $5,495.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $1,148.15 | Professional | None | $102.33 | $120.23 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $933.25 | Facility | None | $660.69 | $660.69 | $933.25 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | None | $660.69 | $660.69 | $707.95 |
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 $251.19 Median $281.84 Typical High $407.38 | Facility | None | $251.19 | $281.84 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $478.63 | Professional | None | $251.19 | $281.84 | $478.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $1,148.15 Typical High $1,230.27 | Professional | None | $281.84 | $1,148.15 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $8,511.38 | Professional | None | $120.23 | $120.23 | $8,511.38 |
United Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $389.05 | Professional | None | $81.28 | $177.83 | $389.05 |
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 $117.49 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $117.49 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $46.77 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $35.48 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $23.44 | $66.07 | $70.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $70.79 | $79.43 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $323.59 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $70.79 |
Where Idaho sits
The same service costs 7.6 times more in Colorado 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· 15th of 51
$282
CO $912RI $120
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.