How much rates vary
Facilitymedian $479 · 10th to 90th $427 to $676Professionalmedian $468 · 10th to 90th $398 to $513
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 $407.38 Median $512.86 Typical High $512.86 | Professional | None | $407.38 | $512.86 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $676.08 | Facility | None | $426.58 | $467.74 | $676.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $676.08 | Professional | None | $407.38 | $467.74 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $512.86 | Facility | None | $407.38 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $512.86 | Professional | None | $407.38 | $489.78 | $512.86 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | None | $269.15 | $269.15 | $316.23 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Facility | None | $446.68 | $446.68 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $512.86 | Professional | None | $389.05 | $467.74 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $912.01 | Facility | None | $371.54 | $537.03 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | None | $446.68 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
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 $208.93 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $51.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $48.98 |
Where Idaho sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 2nd of 51
$468
AK $589OK $389
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.