How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $165.96 Median $186.21 Typical High $208.93 | Professional | None | $165.96 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $91.20 | $97.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $398.11 | Professional | None | $302.00 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $323.59 | Professional | None | $169.82 | $186.21 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $83.18 | $91.20 | $91.20 |
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 $194.98 Median $218.78 Typical High $316.23 | Facility | None | $194.98 | $218.78 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $371.54 | Professional | None | $194.98 | $218.78 | $371.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $331.13 | Professional | None | $257.04 | $302.00 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $398.11 | Professional | None | $173.78 | $186.21 | $398.11 |
United Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $371.54 | Professional | None | $208.93 | $275.42 | $371.54 |
4 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 22 · Increased work | $398.11 | $398.11 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 63 · Small infant | $398.11 | $398.11 | $398.11 |
Where Idaho sits
The same service costs 3.6 times more in Alaska than in New York. 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· 14th of 51
$257
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.