How much rates vary
Facilitymedian $219 · 10th to 90th $123 to $363Professionalmedian $195 · 10th to 90th $91 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 $128.82 Median $194.98 Typical High $194.98 | Professional | None | $128.82 | $194.98 | $194.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $363.08 | Facility | None | $177.83 | $218.78 | $363.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $251.19 | Professional | None | $158.49 | $239.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Facility | None | $125.89 | $125.89 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $194.98 Typical High $223.87 | Facility | None | $58.88 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $239.88 | Professional | None | $151.36 | $194.98 | $239.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $162.18 Typical High $190.55 | Professional | None | $30.20 | $162.18 | $190.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $13,489.63 | Facility | None | $147.91 | $281.84 | $13,489.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $15,848.93 | Professional | None | $223.87 | $281.84 | $15,848.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $323.59 | Facility | None | $208.93 | $218.78 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Professional | None | $158.49 | $158.49 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $223.87 Typical High $288.40 | Facility | None | $208.93 | $223.87 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $245.47 | Professional | None | $147.91 | $223.87 | $245.47 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $134.90 | Professional | None | $85.11 | $91.20 | $134.90 |
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 $74.13 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $19.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $147.91 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $74.13 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $19.50 |
Where Idaho sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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
$195
HI $219DE $91.20
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.