How much rates vary
Facilitymedian $219 · 10th to 90th $191 to $316Professionalmedian $214 · 10th to 90th $191 to $240
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 $269.15 Median $281.84 Typical High $354.81 | Facility | None | $269.15 | $281.84 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | None | $190.55 | $239.88 | $239.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $190.55 Median $213.80 Typical High $316.23 | Facility | None | $190.55 | $213.80 | $316.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $309.03 | Professional | None | $190.55 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $478.63 | Facility | None | $269.15 | $269.15 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $239.88 Typical High $331.13 | Facility | None | $51.29 | $239.88 | $331.13 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $239.88 | Professional | None | $190.55 | $234.42 | $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 $208.93 Median $213.80 Typical High $281.84 | Facility | None | $208.93 | $213.80 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $239.88 | Professional | None | $186.21 | $223.87 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $446.68 | Facility | None | $186.21 | $263.03 | $446.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | None | $208.93 | $229.09 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $398.11 | Facility | None | $190.55 | $190.55 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
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 $95.50 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $23.99 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $23.44 |
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· 5th of 51
$214
AK $234MA $191
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.