How much rates vary
Facilitymedian $263 · 10th to 90th $200 to $646Professionalmedian $257 · 10th to 90th $148 to $447
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 Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | None | $162.18 | $257.04 | $257.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $407.38 Typical High $562.34 | Facility | None | $199.53 | $407.38 | $562.34 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $426.58 Typical High $446.68 | Professional | None | $147.91 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $302.00 | Facility | None | $100.00 | $257.04 | $302.00 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $257.04 | Professional | None | $162.18 | $218.78 | $257.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $288.40 Typical High $346.74 | Professional | None | $30.20 | $288.40 | $346.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $12,589.25 | Facility | None | $251.19 | $263.03 | $12,589.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $14,791.08 | Professional | None | $218.78 | $263.03 | $14,791.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $380.19 | Facility | None | $199.53 | $199.53 | $380.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | None | $147.91 | $147.91 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $407.38 | Professional | None | $208.93 | $346.74 | $407.38 |
United Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $275.42 | Professional | None | $208.93 | $218.78 | $275.42 |
10 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 $81.28 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $25.70 | $25.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $302.00 | $316.23 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $25.70 | $25.70 |
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
$257
HI $490UT $191
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.