How much rates vary
Facilitymedian $912 · 10th to 90th $692 to $1,514Professionalmedian $759 · 10th to 90th $661 to $851
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 $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
BCBS Idaho Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,548.82 | Facility | None | $645.65 | $1,023.29 | $1,548.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | None | $660.69 | $758.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $977.24 Typical High $1,737.80 | Facility | None | $954.99 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $851.14 | Facility | None | $691.83 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $1,047.13 | Facility | None | $758.58 | $794.33 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $851.14 | Professional | None | $676.08 | $812.83 | $851.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $1,548.82 | Facility | None | $630.96 | $912.01 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | None | $758.58 | $812.83 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,445.44 | Facility | None | $691.83 | $691.83 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Professional | None | $691.83 | $691.83 | $977.24 |
United Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
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 $346.74 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
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· 4th of 51
$794
AK $832IN $692
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.