How much rates vary
Facilitymedian $661 · 10th to 90th $407 to $1,622Professionalmedian $631 · 10th to 90th $363 to $1,122
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | None | $407.38 | $630.96 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $489.78 Median $954.99 Typical High $1,412.54 | Facility | None | $489.78 | $954.99 | $1,412.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $1,071.52 Typical High $1,122.02 | Professional | None | $363.08 | $1,071.52 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Facility | None | $758.58 | $758.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $630.96 Typical High $758.58 | Facility | None | $251.19 | $630.96 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $630.96 | Professional | None | $363.08 | $549.54 | $630.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $724.44 Typical High $851.14 | Professional | None | $30.20 | $724.44 | $851.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $630.96 Median $660.69 Typical High $31,622.78 | Facility | None | $630.96 | $660.69 | $31,622.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $37,153.52 | Professional | None | $549.54 | $660.69 | $37,153.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $954.99 | Facility | None | $489.78 | $489.78 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $549.54 | Professional | None | $363.08 | $363.08 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $537.03 | Facility | None | $346.74 | $524.81 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,023.29 | Professional | None | $524.81 | $870.96 | $1,023.29 |
United Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $691.83 | Professional | None | $524.81 | $549.54 | $691.83 |
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 $204.17 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $63.10 | $63.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $63.10 | $63.10 |
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· 28th of 51
$631
HI $1,230UT $479
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.