How much rates vary
Facilitymedian $251 · 10th to 90th $186 to $447Professionalmedian $191 · 10th to 90th $162 to $257
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 $229.09 Median $239.88 Typical High $302.00 | Facility | None | $229.09 | $239.88 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $223.87 | Professional | None | $162.18 | $199.53 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $457.09 | Facility | None | $223.87 | $302.00 | $457.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $457.09 | Professional | None | $177.83 | $190.55 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $407.38 | Facility | None | $223.87 | $229.09 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $478.63 | Facility | None | $162.18 | $199.53 | $478.63 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $239.88 | Professional | None | $162.18 | $199.53 | $239.88 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | None | $131.83 | $131.83 | $154.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $204.17 Typical High $269.15 | Facility | None | $177.83 | $204.17 | $269.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | None | $173.78 | $199.53 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $190.55 Median $269.15 Typical High $457.09 | Facility | None | $190.55 | $269.15 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | None | $177.83 | $190.55 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $316.23 | Facility | None | $162.18 | $162.18 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | None | $162.18 | $162.18 | $229.09 |
United Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | None | $177.83 | $177.83 | $194.98 |
10 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 $81.28 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $19.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $123.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $117.49 | $123.03 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $181.97 Median $269.15 Typical High $575.44 | Professional | JZ · No drug discarded | $181.97 | $269.15 | $575.44 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 8th of 51
$191
WY $302NV $162
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.