How much rates vary
Facilitymedian $324 · 10th to 90th $282 to $457Professionalmedian $309 · 10th to 90th $269 to $347
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 $281.84 Median $346.74 Typical High $346.74 | Professional | None | $281.84 | $346.74 | $346.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $281.84 Median $316.23 Typical High $457.09 | Facility | None | $281.84 | $316.23 | $457.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $457.09 | Professional | None | $281.84 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $398.11 Typical High $707.95 | Facility | None | $389.05 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $346.74 | Facility | None | $281.84 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $346.74 | Professional | None | $281.84 | $338.84 | $346.74 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | None | $181.97 | $181.97 | $213.80 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Facility | None | $309.03 | $309.03 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $346.74 | Professional | None | $263.03 | $323.59 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $251.19 Median $363.08 Typical High $616.60 | Facility | None | $251.19 | $363.08 | $616.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $588.84 | Facility | None | $281.84 | $281.84 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | None | $269.15 | $269.15 | $281.84 |
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 $141.25 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $34.67 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $33.88 | $33.88 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 3rd of 51
$309
AK $339NC $275
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.