How much rates vary
Facilitymedian $617 · 10th to 90th $398 to $1,047Professionalmedian $562 · 10th to 90th $295 to $813
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 $436.52 Median $562.34 Typical High $562.34 | Professional | None | $436.52 | $562.34 | $562.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $1,047.13 | Facility | None | $467.74 | $630.96 | $1,047.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $724.44 | Professional | None | $457.09 | $691.83 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $562.34 Typical High $660.69 | Facility | None | $204.17 | $562.34 | $660.69 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $691.83 | Professional | None | $436.52 | $588.84 | $691.83 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $467.74 Typical High $549.54 | Professional | None | $30.20 | $467.74 | $549.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $562.34 Median $812.83 Typical High $38,904.51 | Facility | None | $562.34 | $812.83 | $38,904.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $45,708.82 | Professional | None | $660.69 | $812.83 | $45,708.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $630.96 Typical High $933.25 | Facility | None | $616.60 | $630.96 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $691.83 | Professional | None | $457.09 | $457.09 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Facility | None | $660.69 | $660.69 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $707.95 | Professional | None | $426.58 | $660.69 | $707.95 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $478.63 | Professional | None | $288.40 | $316.23 | $478.63 |
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 $213.80 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
Where Idaho sits
The same service costs 3.0 times more in Montana than in Florida. 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· 11th of 51
$562
MT $871FL $295
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.