How much rates vary
Facilitymedian $331 · 10th to 90th $240 to $813Professionalmedian $316 · 10th to 90th $178 to $575
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 $204.17 Median $316.23 Typical High $316.23 | Professional | None | $204.17 | $316.23 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $794.33 | Facility | None | $239.88 | $537.03 | $794.33 |
BCBS Idaho Setting Professional Modifier None Typical Low $177.83 Median $549.54 Typical High $575.44 | Professional | None | $177.83 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Facility | None | $380.19 | $380.19 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | None | $281.84 | $281.84 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $251.19 Typical High $346.74 | Facility | None | $120.23 | $251.19 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $316.23 | Professional | None | $204.17 | $263.03 | $316.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $371.54 Typical High $436.52 | Professional | None | $30.20 | $371.54 | $436.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $15,135.61 | Facility | None | $302.00 | $316.23 | $15,135.61 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $17,782.79 | Professional | None | $251.19 | $316.23 | $17,782.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $501.19 | Facility | None | $239.88 | $239.88 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | None | $177.83 | $177.83 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Facility | None | $251.19 | $251.19 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $512.86 | Professional | None | $251.19 | $457.09 | $512.86 |
United Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $323.59 | Professional | None | $239.88 | $257.04 | $323.59 |
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 $102.33 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $102.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $40.74 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $31.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $102.33 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $40.74 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $31.62 |
Where Idaho sits
The same service costs 3.0 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· 27th of 51
$316
HI $661UT $224
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.