How much rates vary
Facilitymedian $302 · 10th to 90th $229 to $513Professionalmedian $257 · 10th to 90th $224 to $282
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 $229.09 Median $281.84 Typical High $281.84 | Professional | None | $229.09 | $281.84 | $281.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $524.81 | Facility | None | $218.78 | $323.59 | $524.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | None | $223.87 | $251.19 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $575.44 | Facility | None | $316.23 | $323.59 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $281.84 | Facility | None | $229.09 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $281.84 | Professional | None | $229.09 | $275.42 | $281.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $338.84 | Facility | None | $251.19 | $257.04 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $281.84 | Professional | None | $218.78 | $263.03 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $524.81 | Facility | None | $213.80 | $309.03 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | None | $251.19 | $269.15 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $478.63 | Facility | None | $229.09 | $229.09 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | None | $229.09 | $229.09 | $323.59 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
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 $114.82 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $28.18 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $154.88 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $147.91 | $154.88 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $27.54 |
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
$257
AK $275VA $229
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.