How much rates vary
Facilitymedian $646 · 10th to 90th $195 to $1,023Professionalmedian $234 · 10th to 90th $151 to $316
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | None | $158.49 | $251.19 | $251.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $1,096.48 | Facility | None | $537.03 | $758.58 | $1,096.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $281.84 | Professional | None | $134.90 | $158.49 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $251.19 Typical High $977.24 | Facility | None | $239.88 | $251.19 | $977.24 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | None | $173.78 | $251.19 | $251.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $323.59 | Facility | None | $194.98 | $223.87 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $380.19 | Professional | None | $194.98 | $223.87 | $380.19 |
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 $239.88 Median $281.84 Typical High $316.23 | Professional | None | $239.88 | $281.84 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $831.76 | Facility | None | $158.49 | $162.18 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $8,511.38 | Professional | None | $158.49 | $158.49 | $8,511.38 |
United Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $389.05 | Professional | None | $186.21 | $257.04 | $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 $93.33 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $93.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $37.15 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $25.12 | $25.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $120.23 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $47.86 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $23.99 | $25.12 | $25.12 |
Where Idaho sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 18th of 51
$240
AK $501CT $158
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.