How much rates vary
Facilitymedian $166 · 10th to 90th $145 to $234Professionalmedian $158 · 10th to 90th $145 to $178
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 $144.54 Median $177.83 Typical High $177.83 | Professional | None | $144.54 | $177.83 | $177.83 |
BCBS Idaho Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $234.42 | Facility | None | $147.91 | $165.96 | $234.42 |
BCBS Idaho Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $234.42 | Professional | None | $144.54 | $158.49 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $363.08 | Facility | None | $199.53 | $204.17 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $177.83 | Facility | None | $144.54 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $177.83 | Professional | None | $144.54 | $169.82 | $177.83 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | None | $97.72 | $97.72 | $114.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $208.93 | Facility | None | $158.49 | $158.49 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $177.83 | Professional | None | $134.90 | $165.96 | $177.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $138.04 Median $194.98 Typical High $331.13 | Facility | None | $138.04 | $194.98 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $302.00 | Facility | None | $144.54 | $144.54 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | None | $144.54 | $144.54 | $147.91 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
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 $72.44 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $17.78 | $17.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $95.50 | $104.71 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $30.20 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $16.98 |
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
$158
AK $178TN $145
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.