How much rates vary
Facilitymedian $457 · 10th to 90th $331 to $759Professionalmedian $363 · 10th to 90th $324 to $417
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 $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $776.25 | Facility | None | $323.59 | $478.63 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | None | $323.59 | $363.08 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $831.76 | Facility | None | $457.09 | $467.74 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Facility | None | $331.13 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $416.87 | Professional | None | $331.13 | $407.38 | $416.87 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $489.78 | Facility | None | $363.08 | $371.54 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $416.87 | Professional | None | $316.23 | $389.05 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $776.25 | Facility | None | $323.59 | $457.09 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | None | $363.08 | $398.11 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $691.83 | Facility | None | $331.13 | $331.13 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | None | $323.59 | $323.59 | $338.84 |
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 $165.96 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $41.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $40.74 | $40.74 |
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· 6th of 51
$363
AK $407VT $331
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.