How much rates vary
Facilitymedian $257 · 10th to 90th $151 to $427Professionalmedian $229 · 10th to 90th $129 to $331
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 $177.83 Median $229.09 Typical High $229.09 | Professional | None | $177.83 | $229.09 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $426.58 | Facility | None | $190.55 | $257.04 | $426.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $295.12 | Professional | None | $186.21 | $281.84 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $229.09 Typical High $263.03 | Facility | None | $83.18 | $229.09 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $281.84 | Professional | None | $177.83 | $239.88 | $281.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $223.87 | Professional | None | $30.20 | $190.55 | $223.87 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $15,848.93 | Facility | None | $213.80 | $331.13 | $15,848.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $18,620.87 | Professional | None | $263.03 | $331.13 | $18,620.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $380.19 | Facility | None | $245.47 | $257.04 | $380.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | None | $186.21 | $186.21 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Facility | None | $263.03 | $263.03 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $288.40 | Professional | None | $173.78 | $263.03 | $288.40 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $194.98 | Professional | None | $120.23 | $128.82 | $194.98 |
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 $87.10 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $87.10 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $22.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $87.10 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $22.91 |
Where Idaho sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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· 13th of 51
$229
HI $324NJ $138
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.