How much rates vary
Facilitymedian $224 · 10th to 90th $166 to $537Professionalmedian $214 · 10th to 90th $123 to $380
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 $138.04 Median $213.80 Typical High $213.80 | Professional | None | $138.04 | $213.80 | $213.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $165.96 Median $346.74 Typical High $478.63 | Facility | None | $165.96 | $346.74 | $478.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $123.03 Median $363.08 Typical High $380.19 | Professional | None | $123.03 | $363.08 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $177.83 Typical High $234.42 | Facility | None | $83.18 | $177.83 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $213.80 | Professional | None | $138.04 | $186.21 | $213.80 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $245.47 Typical High $288.40 | Professional | None | $30.20 | $245.47 | $288.40 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $10,715.19 | Facility | None | $213.80 | $218.78 | $10,715.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $12,589.25 | Professional | None | $177.83 | $218.78 | $12,589.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $323.59 | Facility | None | $165.96 | $165.96 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $186.21 | Professional | None | $123.03 | $123.03 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $181.97 | Facility | None | $177.83 | $177.83 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $338.84 | Professional | None | $177.83 | $295.12 | $338.84 |
United Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $234.42 | Professional | None | $173.78 | $186.21 | $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 $69.18 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $27.54 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $21.38 | $21.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $27.54 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $21.38 | $21.38 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 30th of 51
$214
HI $417UT $162
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.